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陈 真,宋为群,王昇晗,吴江涛,王桂芳,刘 波,袁 英,杜巨豹.电针刺激治疗脑干梗死尿潴留患者的疗效研究[J].中国康复医学杂志,2008,23(10):900~902
电针刺激治疗脑干梗死尿潴留患者的疗效研究    点此下载全文
陈 真  宋为群  王昇晗  吴江涛  王桂芳  刘 波  袁 英  杜巨豹
首都医科大学宣武医院康复医学科,北京市宣武区长椿街45号,100053
基金项目:国家自然科学基金(批准号: 30770714,30540058);北京市自然科学基金(批准号:7052030),北京市市委组织部基金(批准号:20071D0501800243 )。
DOI:
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摘要:
      目的:评估电针刺激治疗脑干梗死后长期尿潴留患者的临床效果。方法:脑干梗死后尿潴留超过6个月的患者16例。对照组8例常规导尿,治疗组8例采用100mm电针经皮刺激双侧骶2、3神经根,持续30min,每周治疗5次,疗程1—3个月。通过排尿日记、生存质量评分和尿流动力学检查评价疗效,随访1年。结果:治疗组7例患者治疗结束时能自主排尿,平均生存质量评分下降2.2分,充盈末期逼尿肌压力由8.49±5.33cmH2O增加到34.66±6.49cmH2O(P<0.05), 平均残余尿量由277.37±43.66ml减至47.56±22.72ml(P<0.01)。对照组的尿动力学及生存质量评分与治疗组相比差异有显著性意义(P<0.05)。治疗后1年随访结果,治疗组5例可自主排尿,各项指标与治疗结束时比较无显著性差异;对照组仅两例恢复自主排尿功能,且平均残余尿量和充盈末期逼尿肌压力均差于治疗组(P<0.05)。治疗组无明显相关不良反应及并发症。结论:电针刺激骶神经根增加了脑干梗死后遗症期尿潴留患者逼尿肌的有效收缩,显著改善膀胱排尿功能障碍。
关键词:脑干梗死  神经源性膀胱  尿潴留  电刺激
Effect of electroacupuncture stimulation on long-term urinary retention after brain stem infarction    Download Fulltext
Xuanwu Hospital of Capital Medical University, Beijing, 100053
Fund Project:
Abstract:
      Objective:To assess the clinical efficacy of electroacupuncture at sacral nerve root in patients with long-term urinary retention caused by brain stem infarction. Method:A total of 16 patients with urinary retention lasting for more than 6 months after brain stem infarction were divided into two groups,8 patients for each group. The control group was treated with conventional catheterization, and the therapeutic group was treated with electroacupuncture at bilateral sacral nerve root. The stimulation lasted for 30min, one times per day, and 5 times per week. The sessions were 1 to 3 months. The clinical efficacy were evaluated by voiding diaries, quality of life(QOL) score and urodynamic examination. The follow up were taken one year later. Result:In therapeutic group after electroacupuncture 7 patients could micturate on self-determination, the average QOL score declined by 2.2 points, the maximum detrusor pressure increased from 8.49±5.33cmH2O to 34.66±6.49cmH2O(P<0.05) and the average residual volume decreased from 277.37±43.66ml to 47.56±22.72ml(P<0.01).In control group, there were significant differences in scores of urodynamics and QOL compared with therapeutic group. One year later, in therapeutic group 5 patients could micturate on self-determination, in control group only 2 patients could. Both average residual volume and the maximum detrusor pressure in control group were worse than that in therapeutic group. No side effects were observed. Conclusion:Electroacupuncture at bilateral sacral nerve root serves as an effective and safe method for patients with long-term urinary retention after brain stem infarction.
Keywords:brain stem infarction  neurogenic bladder  urinary retention  electroacupuncture
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