体表舐神经电刺激结合胫神经电刺激治疗脊髓损伤后神经源性膀胱30例临床观察|刘奕漆伟徐贞杰潘科石卫华尚青龙李伟谭一徐立新△(重庆三峡中心医院康复科重庆万州404000)摘要：目的：观察体表砥神经电刺激结合胫神经电刺激对脊髓损伤麻神经源性膀胱的疗效及其对尿流动力学指标的影响。方法:将脊髓损伤神经源性膀胱患者30例完全随机分为对照组和治疗组,对照组(n二15)予综合康复治疗和膀胱训练4周,治疗组(n=15)在综合康复治疗和膀胱训练4周的基础上，加用体表紙神经电刺激结合胫神经电刺激治疗。治疗前、示分别比较患者排尿口记、脊髓损伤神经学分类国际标准评分和尿流动力学检测结果。结果：经4周治疗后，两组患者24小时排尿次数无明显差异(/>0.05),但24小时尿失禁次数、每次排尿量及残余尿量比较，治疗组改善情况明显优于对照(A0.05)；两组治疗后神经功能评分无明显罢异(均00.05)。治疗组治疗4周后尿流动力学检杳结果显示，最大膀胱容积增加(/<0.05),充盈期逼尿肌压力下降(7K0.05),最大尿道压增加(ZKO.05)。结论：体表紙神经电刺激结合胫神经电刺激能优化综合康复治疗和膀胱训练等常规治疗对脊髓损伤后神经源性膀胱的治疗效果。关键词：电刺激；脊髓损伤；神经源性膀胱；尿流动力学。:R493Surfacesacralnervestimulationcombinedwithelectricalstimulationtreatmentontibialof30casesofneurogenicbladderafterspinalcordinjuryclinicalobservationLiuYi,QiWei,XuZhen激e,PanKe,ShiWeihua,ShangQinglong,Liwei,Taiiyi,XuLixin'基金项目：重庆市重点学科基金资助项目(2008-47)。△通讯作者：徐立新，男，主任医师，研究方向：骨与关节、脊髓损伤的临床康复研究，E-mail：xulixin20121120@163第1作者:刘奕(1978-),女,汉族,重庆万州人,主治医师，研究方向：脊髓损伤的临床康复研究,Tel:13594485888,E-mail:757774027@qq(TheRehabilitationDivisionofChongqingThreeGorgesCentralHospitalWanzhou,Chongqing404000)Abstract:Objective:Toexploretheclinicalandurodynamiceffectsofsacralsurfacetherapeu---本文于网络，仅供参考，勿照抄，如有侵权请联系删除---ticelectricalnervestimulation(SS-TENS)andtibialnerveelectricalstimulation(TNES)onneurogenicbladderafterspinalcordinjury(SCI).Methods:30patientswithSCIwererandomlydividedintotwogroups:controlgroupandtreatmentgroup,thecontrolgroup(n=15)weregivenconventionalrehabilitationtherapyandbladdertrainingfor4weeks,thetreatmentgroup(n=15)weregivenconventionalrehabilitationtherapyandbladdertraimngfor4weeks,duringthisperiodtheyweretreatedwithSS-TENSandTNES.ThechangesoftheASIAscores,urinatedairyandurodynamicinvestigationbeforeandaftertreatmentwererecord.Results:Aftertreatment,the24-hourvoidingfrequencywasnosignificantdifference(P>0.05),butthe24-hoururinaryincontinence,eachvoidedvolumeandresidualurinecomparison,thetreatmentgroupimprovedsignificantlybetterthanthecontrolgroup(P<0.05).TherewasnosignificantdifferencebetweenthecontrolgroupandthetreatmentgroupontheASIAscoresaftertreatment(P>0.05).Theresultsofurodynamicinvestigationintreatmentgroupshowedthatmaximumcystometriccapacitywassignificantlyincreased(P<0.05),maxurethalpressurewassignificantlyincreased(P<0.05),detrusorpressureatretentionwassignificantlydecreased(PvO.05),maxurineratewassignificantlyincreased(P<0.05).Conclusion:SS-TENSandTNEScouldenhancethetherapeuticeffectsofconventionalrehabilitationtherapyandbladdertrainingtothefunctionofneurogenicbladderinpatientswithspinalcordinjury-Keywords:electricalstimulation;spinalcordinjury;neurogenicbladder;urodynamics膀胱的正常生理活动是协调尿液储存和排泄，这种协调活动是rh屮枢神经系统(脑和脊髓)调节的脊髓反射。脊髓损伤(spinalcordinjury,SCI)后因神经环路受损导致其出现逼尿肌反射亢进、...