文章摘要

重复经颅磁刺激结合间歇导尿对脊髓损伤后神经源性膀胱患儿的尿动力学及排尿功能的影响

作者: 1黄姣姣, 1尚清, 1张会春, 1韩亮
1 郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院康复中心,郑州 450053
通讯: 尚清 Email: sqing1965@163.com
DOI: 10.3978/j.issn.2095-6959.2022.04.010

摘要

目的:分析重复经颅磁刺激(repeated transcranial magnetic stimulation,rTMS)结合间歇导尿对脊髓损伤后神经源性膀胱患儿的尿动力学及排尿功能的影响。方法:将2019年1月至2021年郑州大学附属儿童医院收治的60例脊髓损伤后神经源性膀胱患儿作为研究对象,根据入院先后顺序编号,采用随机数字表法分为对照组(n=30)与观察组(n=30),均予以间歇导尿,观察组在此基础上进行rTMS治疗,对比两组患儿临床疗效、尿动力学、排尿功能及排尿症状评分。结果:观察组临床有效率高于对照组(P<0.05);治疗后,两组膀胱初感觉、最大膀胱容量、残余尿量及膀胱内压力均改善(P<0.05),且观察组改善程度大于对照组(P<0.05);治疗后,两组日均单次排尿量均升高(P<0.05),日均排尿次数、日均尿失禁次数均降低(P<0.05),且观察组日均单次排尿量高于对照组(P<0.05),日均排尿次数、日均尿失禁次数均低于对照组(P<0.05);治疗后,两组核心下尿路症状评分(Core Lower Urinary Tract Symptom Score,CLSS)、泌尿症状困扰评分量表(Urinary Symptom Distress Scale,USDS)评分均降低(均P<0.05),且观察组CLSS、USDS评分均低于对照组(P<0.05)。结论:rTMS结合间歇导尿可以改善脊髓损伤后神经源性膀胱患儿尿动力学及排尿功能,促使其正常排尿,临床效果显著。
关键词: 脊髓损伤后神经源性膀胱;重复经颅磁刺激;间歇导尿;尿动力学;排尿功能

Effects of repetitive transcranial magnetic stimulation combined with intermittent catheterization on urodynamics and urination function in children with neurogenic bladder after spinal cord injury

Authors: 1HUANG Jiaojiao, 1SHANG Qing, 1ZHANG Huichun, 1HAN Liang
1 Rehabilitation Center, Children’s Hospital Affiliated of Zhengzhou University/Henan Children’s Hospital/Zhengzhou Children’s Hospital, Zhengzhou 450053, China

CorrespondingAuthor: SHANG Qing Email: sqing1965@163.com

DOI: 10.3978/j.issn.2095-6959.2022.04.010

Abstract

Objective: To analyze the effects of repetitive transcranial magnetic stimulation (rTMS) combined with intermittent catheterization on the urodynamics and urination function in children with neurogenic bladder after spinal cord injury. Methods: Sixty children with neurogenic bladder after spinal cord injury treated in the hospital between January 2019 and 2021 were selected as the research subjects. The children were numbered according to the order of admission and were divided into a control group (n=30) and an observation group (n=30). All the children were given intermittent catheterization, and the observation group was treated with rTMS on this basis. The clinical efficacy, urodynamics, urination function and urinary symptoms scores were compared between the two groups. Results: The clinical effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, the urodynamic indicators (initial bladder sensation, maximum bladder capacity, residual urine volume, intravesical pressure) were improved in the two groups (P<0.05), and the improvements in the observation group were greater than those in the control group (P<0.05). After treatment, the average daily single urine output of the two groups was increased (P<0.05) while the average daily urination frequency and average daily frequency of urinary incontinence were decreased (P<0.05), and the average daily single urine output of the observation group was more than that of the control group (P<0.05) while the average daily urination frequency and average daily frequency of urinary incontinence were less than those of the control group (P<0.05). The scores of Core Lower Urinary Tract Symptom Score (CLSS) and Urinary Symptom Distress Scale (USDS) were reduced in the two groups after treatment (P<0.05), and the scores of CLSS and USDS of the observation group were lower than those of the control group (P<0.05). Conclusion: rTMS combined with intermittent catheterization can improve the urodynamics and urination function and promote normal urination of children with neurogenic bladder after spinal cord injury, with significant clinical effects.
Keywords: neurogenic bladder after spinal cord injury; repetitive transcranial magnetic stimulation; intermittent catheterization; urodynamics; urination function