摘要
目的观察揿针、重复功能性磁刺激联合膀胱功能训练、间歇导尿治疗脑卒中恢复期尿失禁的临床疗效。方法将90例脑卒中恢复期尿失禁患者随机分为治疗组和对照组,每组45例。两组均采用脑卒中常规内科综合治疗及基础尿失禁护理,对照组在此基础上给予膀胱功能训练及间歇导尿,治疗组在对照组治疗措施的基础上加用揿针及重复功能性磁刺激。两组均连续治疗12个疗程(12周),观察并比较两组尿动力学指标(残余尿量、最大膀胱容量、最大尿流速率)、排尿日记指标(24 h尿失禁次数、24 h排尿次数)、膀胱过度活动症症状评分(OABSS)、生活质量(QOL)评分的变化情况。结果 (1)治疗前后组内比较,两组残余尿量减少(P<0.05),最大膀胱容量、最大尿流速率增大(P<0.05);组间治疗后比较,治疗组残余尿量少于对照组(P<0.05),最大膀胱容量、最大尿流速率大于对照组(P<0.05)。(2)治疗前后组内比较,两组24 h排尿次数、24 h尿失禁次数减少(P<0.05);组间治疗后比较,治疗组24 h排尿次数、24 h尿失禁次数均少于对照组(P<0.05)。(3)治疗前后组内比较,两组OABSS、QOL评分降低(P<0.05);组间治疗后比较,治疗组OABSS、QOL评分低于对照组(P<0.05)。结论与膀胱功能训练、间歇导尿相比,加用揿针、重复功能性磁刺激治疗脑卒中恢复期尿失禁疗效满意,能有效缓解尿失禁症状,改善尿动力学指标,提高患者的生活质量。
Objective training and intermittent catheterization in the treatment of urinary incontinence during recovery from stroke.MethodsNinety patients with urinary incontinence during stroke recovery were randomly divided into the treatment group(n=45)and the control group(n=45). Both groups were treated with conventional and comprehensive internal medicine treatment for stroke and basic nursing for urinary incontinence. The control group was administered with bladder function training and intermittent catheterization,and the treatment group was administered with press needle and repeat functional magnetic stimulation besides the treatment measures of the control group. Both groups were treated continuously for 12 sessions. The changes of urodynamic indexes(residual urine volume,maximum bladder volume,maximum urinary flow rate),voiding diary indexes(24-h urinary incontinence frequency,24-h voiding frequency),overactive bladder symptom score(OABSS),and quality of life(QOL)score were observed and compared between the two groups.Results and maximum urinary flow rate increased(P<0.05)in both groups;after treatment,the residual urine volume in the treatment group was lower than that in the control group(P<0.05),and the maximum bladder volume and maximum urinary flow rate were higher than those in the control group(P<0.05).(2)After treatment,the 24-h voiding frequency and 24-h incontinence frequency decreased in both groups(P<0.05);After treatment,the 24-h voiding frequency and 24-h incontinence frequency in the treatment group were lower than those in the control group(P<0.05).(3) After treatment,OABSS and QOL scores decreased in both groups(P<0.05);After treatment,OABSS and QOL scores in the treatment group were lower than those in the control group(P<0.05).ConclusionCompared with the conventional treatment with bladder function training and intermittent catheterization,the additional use of press needle and repeat functional magnetic stimulation in the treatment of urinary incontinence during stroke recovery has satisfactory results,which can effectively relieve the symptoms of urinary incontinence,improve the urodynamic indexes and the quality of life of patients.
作者
刘薇
麻佳健
杨迎民
朱文宗
金永喜
张艳艳
张蒙梦
LIU Wei;MA Jiajian;YANG Yingmin;ZHU Wenzong;JIN Yongxi;ZHANG Yanyan;ZHANG Mengmeng(Department of Rehabilitation,Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Wenzhou,Zhejiang 325000,China)
出处
《上海中医药杂志》
2022年第1期67-70,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
浙江省自然科学基金项目(LGF18H270001)
温州市科技局科研项目(20190729)。
关键词
脑卒中
尿失禁
揿针
重复功能性磁刺激
膀胱功能训练
间歇导尿
stroke
urinary incontinence
press needle
repeat functional magnetic stimulation
bladder function training
intermittent catheterization
