[1]罗娟,刘倩. 不同功能性电刺激方案联合生物反馈治疗儿童神经源性逼尿肌尿道无收缩尿失禁的疗效[J].中国医学物理学杂志,2018,35(4):461-465.[doi:DOI:10.3969/j.issn.1005-202X.2018.04.017]
　LUO Juan,LIU Qian. Therapeutic effect of different functional electric stimulations combined with biofeedback in children with urinary incontinence due to neuropathic acontractile detrusor and sphincter[J].Chinese Journal of Medical Physics,2018,35(4):461-465.[doi:DOI:10.3969/j.issn.1005-202X.2018.04.017]
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 不同功能性电刺激方案联合生物反馈治疗儿童神经源性逼尿肌尿道无收缩尿失禁的疗效()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
35卷
期数:
2018年第4期
页码:
461-465
栏目:
医学生物物理
出版日期:
2018-04-21

文章信息/Info

Title:
 Therapeutic effect of different functional electric stimulations combined with biofeedback in children with urinary incontinence due to neuropathic acontractile detrusor and sphincter
文章编号:
1005-202X（2018）04-0461-05
作者:
 罗娟1; 刘倩2
 1.山东大学第二医院儿外科特检， 山东 济南 250000； 2.山东大学第二医院小儿外科， 山东 济南 250000
Author(s):
 LUO Juan1;  LIU Qian2
 1. Department of Special Inspection of Pediatric Surgery, the Second Hospital of Shandong University, Ji’nan 250000, China; 2. Department of Pediatric Surgery, the Second Hospital of Shandong University, Ji’nan 250000, China
关键词:
 ; 尿失禁; 功能性电刺激; 生物反馈; 尿动力学
Keywords:
 ; urinary incontinence;  functional electric stimulation;  biofeedback;  urodynamics
分类号:
R726.9
DOI:
DOI:10.3969/j.issn.1005-202X.2018.04.017
文献标志码:
A
摘要:
 目的：研究不同功能性电刺激（FES）方案联合生物反馈治疗儿童神经源性逼尿肌尿道无收缩（NADS）尿失禁的疗效。 方法：纳入68例NADS尿失禁患儿，采用随机数字表法分为对照组（n=34）和观察组（n=34）。对照组在每次治疗中，均以患儿可耐受的初始阈电流强度进行FES联合生物反馈治疗；观察组则在每次治疗中期，在初始阈电流基础上增加电流强度至患儿可耐受的新的阈刺激强度，并持续至治疗结束。每次治疗时间为40 min，每周3次，疗程为12周。在治疗结束后至少6个月门诊随访疗效。分析两组治疗前后及随访6个月时的尿动力学检查（UDS）指标与尿失禁症状，对比两种方案疗效。 结果：两组患儿治疗结束及随访6个月时，UDS指标逼尿肌漏尿点压、膀胱容量、逼尿肌最大压力、逼尿肌顺应性与尿失禁症状72 h总排尿次数、总尿失禁次数、国际尿失禁咨询委员会问卷评分均明显改善（P<0.05），且观察组均显著优于对照组（P<0.05）；治疗结束及随访6个月时，观察组总有效率均显著高于对照组（P<0.05）。 结论：FES联合生物反馈治疗儿童NADS尿失禁，疗效确切且持续稳定，治疗中期增加电流强度方案疗效更佳，临床应用价值高。
Abstract:
 Objective To evaluate the efficacy of functional electric stimulation (FES) combined with biofeedback treatment for children with urinary incontinence due to neuropathic acontractile detrusor and sphincter (NADS). Methods Sixty-eight children with urinary incontinence due to NADS were enrolled and randomly divided into control group and observation group, 34 children in each group. The children in control group received the initial threshold of FES and biofeedback treatment during the whole treatment. In observation group, the current was increased in the middle of treatment until it reached a new tolerable threshold of intensity, and the increased current lasted until the end of treatment. A 12-week treatment was performed for 40 minutes each time and 3 times per week. After the completion of treatment, the children were followed-up at least for 6 months. The indices of urodynamic study and incontinence symptoms of pre- and post-treatment and 6 month later were assessed in order to compare the treatment efficacy between the two groups. Results The evaluation performed at the completion of treatment and 6 months after the treatment showed that the children in both groups had significant improvements in the indices of urodynamic study including detrusor leak point pressure, maximal detrusor pressure, maximum bladder capacity and mean detrusor compliance, and incontinence symptoms such as 72 h total urinary volume, total voiding times total incontinence times, and the score of international continence inquiring committee’s questionnaire (P<0.05). Moreover, those improvements in observation group were superior to those in control group (P<0.05). The observation group had higher overall effective rate compared to control group (P<0.05). Conclusion FES combined with biofeedback has a clear and stable therapeutic effect in the pediatric patients with urinary incontinence due to NADS. Moreover, increasing the current in the middle of the treatment could achieve a better clinical outcome, with a higher clinical value.

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备注/Memo

备注/Memo:
 【收稿日期】2017-11-17
【基金项目】山东省医药卫生科技发展计划（2015WS0312）
【作者简介】罗娟，住院医师，主要从事儿童尿失禁研究，E-mail: lj_sdey@163.com
更新日期/Last Update: 2018-04-23