王梦婷,秦义婷,程清,等.骶神经磁刺激对逼尿肌无力的影响[J].中华物理医学与康复杂志,2020,42(8):729-733
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| 骶神经磁刺激对逼尿肌无力的影响 |
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| DOI：10.3760/cma.j.issn.0254-1424.2020.08.014 |
| 中文关键词: 骶神经磁刺激 逼尿肌无力 最大逼尿肌压力 |
| 英文关键词: Sacral nerve Magnetic stimulation Acontractile detrusors Detrusor pressure |
| 基金项目: |
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| 摘要点击次数: 4723 |
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| 中文摘要: |
| 目的 探讨骶神经磁刺激（SMS）对逼尿肌无力型神经源性膀胱的影响。 方法 选取30例脊髓损伤合并神经源性膀胱患者采用随机分组方法分为刺激组和假刺激组，每组15例。实验一，刺激组第1天在膀胱容量为100 ml时给予1次SMS，第2天在膀胱容量为200 ml时给予1次SMS，第3天在膀胱容量为300 ml时给予1次SMS。SMS参数：刺激频率为15 Hz，刺激时间10 s，间歇时间30 s，共1500次脉冲。假刺激组SMS参数与刺激组相同，但将磁刺激线圈旋转90°；2组患者在100、200和300 ml膀胱容量下，在每次SMS刺激前和刺激后即刻检测最大逼尿肌压力（MDP）。实验二，从第4天开始，刺激组接受SMS治疗，假刺激组接受假刺激，均为每日治疗2次，每周治疗5 d，共治疗4周；分别于治疗前和治疗4周后，检测2组患者膀胱容量为0、100、200和300 ml时的MDP。 结果 实验一，SMS刺激后即刻，刺激组在膀胱容量为200和300 ml时的MDP均较刺激前明显增加（P＜0.05），且均较同时间点假刺激组明显增加（P＜0.05），而在膀胱容量为100 ml时，刺激前与刺激后即刻MDP未见明显变化（P＞0.05）。实验二，治疗4周后刺激组患者在膀胱容量为100、200和300 ml时的MDP均较治疗前明显增高（P＜0.05），且明显优于同时间点假刺激组（P＜0.05）。 结论 SMS治疗对逼尿肌无力有效，但有效性可能与膀胱容量有关。 |
| 英文摘要: |
| Objective To investigate anye effect of magnetic stimulation of the sacral nerve (SMS) on acontractile detrusor disorder. Methods Thirty spinal cord injury patients with neurogenic bladder dysfunction were randomly divided into a stimulation group and a sham group, each of 15. In a first experiment the stimulation group was treated with SMS (over S3) with a bladder volume of 100ml on the 1st day, 200ml on the 2nd day, and 300ml on the 3rd day. Each SMS session involved a total of 1500 pulses at 15Hz in 10-second bursts with 30-second intervals. For the sham group the treatment was ostensibly identical, but the coil was rotated 90 degrees. Maximum detrusor pressure was assessed before and immediately after each SMS session. In a second experiment the bladder volumes were adjusted to 200-300ml ultrasonically before treatment. Both groups were treated twice a day, 5 days a week for 4 weeks. Maximum detrusor pressures were detected at the bladder volumes of 0ml, 100ml, 200ml and 300ml before and after the 4 weeks of treatment. Results The stimulation group′s average pressures at 200ml and 300ml had increased significantly immediately after SMS and were then significantly higher than the sham group′s averages. After 4 weeks of treatment the stimulation group′s maximum pressures were significantly higher than before treatment at all of the bladder volumes tested, and were significantly better than those of the sham group. Conclusions SMS can significantly improve detrusor functioning, but the effect is related to bladder volume. |
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