摘要
目的探究重复经颅磁刺激(rTMS)治疗脊髓损伤后逼尿肌无反射型神经源性膀胱的效果。方法选取山东省日照市人民医院2018年1月—2023年6月收治的60例脊髓损伤后神经源性膀胱患者为研究对象,按照随机数字法将其分为对照组(n=30)及观察组(n=30)。对照组采用传统的间歇性导尿法,在此基础上,观察组进行rTMS治疗。治疗前及治疗后4、14、24周,比较两组患者的尿动力学、Barthel指数(BI)评分、脊髓损伤或功能障碍生活质量评定量表(SCIDQLRS)评分及并发症发生率。结果治疗后4、14、24周,两组残余尿量均少于治疗前,膀胱内压均高于治疗前,且观察组残余尿量均少于对照组,膀胱内压均高于对照组,差异有统计学意义(P<0.05);BI评分、SCIDQLRS评分均高于治疗前,且观察组均高于对照组,差异有统计学意义(P<0.05)。治疗后4、14、24周,两组的最大膀胱容量均较治疗前下降,差异有统计学意义(P<0.05);但同时段两组间比较,组间差异无统计学意义(P>0.05)。观察组的尿路感染发生率为46.67%,低于对照组的70.00%,差异有统计学意义(P<0.05);两组的肾结石(或肾积水)、肾功能不全发生率比较,组间差异无统计学意义(P>0.05)。结论rTMS联合间歇性导尿应用于脊髓损伤后逼尿肌无反射型神经源性膀胱患者中,能有效改善其尿动力学、日常生活能力及生活质量,降低尿路感染发生率,且临床效果呈可持续性。
Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)in the treatment of detrusor non-reflective neurogenic bladder after spinal cord injury.Methods Sixty patients with neurogenic bladder after spinal cord injury admitted to Rizhao People's Hospital of Shandong Province from January 2018 to June 2023 were selected as the research objects,and were divided into a control group(n=30)and an observation group(n=30)according to random number method.The control group was treated with traditional intermittent catheterization,on the basis of which,the observation group was treated with rTMS.The urodynamics,Barthel index(BI)score,spinal cord injury or dysfunction quality of life rating scale(SCIDQLRS)score and complication rate were compared between the two groups before treatment and 4,14 and 24 weeks after treatment.Results At 4,14 and 24 weeks after treatment,the residual urine volume in both groups was lower than before treatment,and the internal bladder pressure was higher than before treatment,and the residual urine volume in the observation group was lower than that in the control group,and the internal bladder pressure was higher than that in the control group,with statistical significance(P<0.05);BI and SCIDQLRS score were higher than before treatment,and observation group were higher than those in control group,the difference was statistically significant(P<0.05).At 4,14 and 24 weeks after treatment,the maximum bladder volumes of both groups decreased compared with that before treatment,the differences were statistically significant (P<0.05);however, there were no significant differences between the two groups at the same time (P>0.05). The incidence of urinary tract infection in the observation group was 46.67%, lower than 70.00% in the control group, and the difference was statistically significant (P<0.05);there were no significant differences in the incidences of kidney stones (or hydronephrosis) and renal insufficiency between the two groups (P>0.05). Conclusion rTMS combi
作者
崔荣荣
胡晓丽
王小雨
李常辉
CUI Rongrong;HU Xiaoli;WANG Xiaoyu;LI Changhui(Department of Rehabilitation Medicine,Rizhao People's Hospital,Shandong Province,Rizhao 276800,China)
出处
《反射疗法与康复医学》
2024年第18期58-62,共5页
Reflexology And Rehabilitation Medicine
基金
日照市自然科学基金(RZ2021RZ60)。
关键词
脊髓损伤
逼尿肌无反射型神经源性膀胱
重复经颅磁刺激
间歇性导尿
尿动力学
日常生活能力
Spinal cord injury
Detrusor non-reflective neurogenic bladder
Repetitive transcranial magnetic stimulation
Intermittent catheterization
Urodynamics
Ability of daily living.
