摘要目的 观察早期电针联合体表神经电刺激治疗脊髓损伤后神经源性膀胱的疗效.方法 采用随机数字表法将40例脊髓损伤后神经源性膀胱患者分为对照组及观察组,每组20例.对照组患者给予体表神经电刺激治疗,观察组患者在体表神经电刺激基础上辅以电针治疗.于治疗前、治疗2个月后通过尿流动力学检查评价2组患者膀胱排尿情况,并将所得数据进行统计学分析.结果 治疗前2组患者最大膀胱容量、充盈期逼尿肌压力、最大尿道闭合压、最大尿流率和残余尿量等指标组间差异均无统计学意义(P＞0.05),经治疗2个月后发现观察组患者最大膀胱容量[(369.2±76.5)ml]、最大尿道闭合压[(75.4±10.5)cmH2O]和最大尿流率[(12.3 ±3.3)ml/s]均明显高于对照组水平,而充盈期逼尿肌压力[(21.8±5.7)cmH2O]、残余尿量[(85.4 ±41.8)ml]均明显低于对照组水平,组间差异均具有统计学意义(P＜0.05).结论 电针联合体表神经电刺激早期治疗可显著改善脊髓损伤后神经源性膀胱患者膀胱功能,该联合疗法值得临床推广、应用.

abstractsObjective To observe the therapeutic effect of surface functional electrical stimulation combined with electroacupuncture on neurogenic bladder after the spinal cord injury.Methods Forty cases of neurogenic bladder after the spinal cord injury were randomly divided into a control group (n =20) and a combination group (n =20).The combination group was treated with surface functional electrical stimulation combined with electroacupuncture on the basis of internal urethral catheterization,while the control group was treated with surface functional electrical stimulation on the basis of internal urethral catheterization.The bladder urination was tested using urodynamic study before and after two months of treatment.Results There was no significant difference between the 2 groups in the average maximum bladder capacity,detrusor pressure at filling time,maximal urethral closure pressure,maximum urine flow rate and residual urine volume before the treatment.After the treatment,however,the average maximum bladder capacity,maximal urethral closure pressure and maximum urine flow rate in the combination group were significantly higher than those of the control group,while the average detrusor pressure at filling time and the residual urine volume of the combination group were significantly lower than the control group.Conclusion Surface functional electrical stimulation combined with electroacupuncture could remarkably improve bladder function of patients with the neurogenic bladder after the spinal cord injury.