| 神经源性膀胱引起排尿障碍的疗效观察 |
| 投稿时间：2014-11-21 修订日期：2014-12-29 点此下载全文 |
| 引用本文：杜耀军,刘路然,刘畅,赵浩,李海霞.神经源性膀胱引起排尿障碍的疗效观察[J].医学研究杂志,2015,44(7):149-151,131 |
| DOI：
10.11969/j.issn.1673-548X.2015.07.042 |
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| 中文摘要:目的 探讨电针治疗神经源性膀胱(neurogenic bladder,NB)的临床应用疗效。方法 回顾性分析笔者医院2012年12月~2014年5月接受治疗的135例神经源性膀胱患者的临床资料。根据病因分为脑卒中组、糖尿病组及脊髓损伤组,每组均为45例。所有患者均采用电针、常规治疗和膀胱功能锻炼相结合的方法治疗。监测3组治疗前、后的膀胱残余尿量(RV)、初始尿意膀胱容量(FDV)、最大尿流率(Qmax)和最大膀胱容量(MCC)的数值,并进行比较和分析;观察3组不良反应发生情况。结果 所有患者治疗均顺利进行,2周后脑卒中组有效率为95.5%,脊髓损伤组有效率为86.7%,均显著高于糖尿病组(60.0%,P<0.05);3组患者尿流动力学指标较治疗前均明显改善(P<0.05);脑卒中组与脊髓损伤组尿动力学指标分别为Qmax 5.4±7.6ml/s,19.3±3.2ml/s;RV67.2±16.3ml,43.5±12.7ml;FDV87.4±34.9ml,67.9±45.3ml;MCC 321.9±87.3ml,273.6±64.5ml,均优于糖尿病组Qmax 11.8±3.7ml/s,RV 98.7±11.3ml,FDV 173.8±57.9ml,MCC 374.2±90.4ml,P<0.05)。脊髓损伤组无泌尿系感染发生,糖尿病组有3例,脑卒中组有2例发生泌尿系感染,给予膀胱冲洗及实用抗生素3~5 天后症状消失;3组均未出现泌尿系结石、肾积水和肾功能损害等不良现象。结论 电针治疗脑卒中性及脊髓损伤性神经源性膀胱可获得理想临床疗效,而其对糖尿病性神经源性膀胱的疗效欠佳。 |
| 中文关键词:神经源性膀胱 排尿障碍 尿潴留 尿失禁 尿流动力学 |
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| Observation on the Curative Effect of Urination Disorders Caused by Neurogenic Bladder |
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| Abstract:Objective To explore the clinical application effect of electro acupuncture in the treatment of neurogenic bladder. Methods 135 cases of patients with neurogenic bladder admitted from Dec 2012 to May 2014 were enrolled for the retrospective analysis. According to the etiology, the patients were divided into the stroke group,the diabetes group and the spinal cord injury group,with 45 patients in each group. All patients were treated with the combined therapy methods of electroacupuncture,conventional therapy and bladder function training.The maximum urinary flow rate (Qmax),residual volume(RV),first desire to void(FDV) and maximum cystometric capacity(MCC) were recorded before and after treatment, And the results were compared and analyzed,and the occurrence of aderse reaction of three groups was oberserved.Results All the patients were treated successfully.After 2 weeks compared with efficiency,the stroke group was 95.5% and the spinal cord injury group was 86.7% which was significantly higher than the diabetic group [60.0%, P<0.05]. Three groups of patients with urodynamic index compared with those before treatment were significantly improved (P<0.05). The urodynamic indexes of stroke group and spinal cord injury group were Qmax (5.4+7.6)ml/s/(19.3+3.2)ml/s, RV (67.2+16.3)ml/(43.5+2.7)ml, FDV(87.4+34.9)ml/(67.9+45.3)ml, MCC (321.9+87.3)ml/(273.6+64.5)ml. The indexes of two groups were better than that of diabetic group [Qmax (11.8+3.7) ml/s, RV (98.7+11.3) ml, FDV (173.8+57.9)ml, MCC (374.2+90.4) ml, P<0.05]. No urinary tract infection occurred in spinal cord injury group, 3 cases in diabetes group, 2 cases of urinary tract infection in cerebral stroke group. Symptoms disappeared 3-5 days after giving bladder irrigation and antibiotic. The three groups had no urinary calculi, hydronephrosis, renal function damage and other adverse phenomenon. Conclusion After electroacupuncture therapy,both the cerebral apoplectic and injury of spinal cord neurogenic bladder could obtain ideal clinical efficacy,however,its effect on diabetic neurogenic bladder would be poor. |
| keywords:Neurogenic bladder Urination disorder Urinary retention Urinary incontinence Urodynamics |
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