盆底肌电刺激联合盆底肌电生物反馈治疗对脊髓损伤后尿失禁治疗效果的分析

目的:探讨盆底肌电刺激联合盆底肌电生物反馈治疗对脊髓损伤(SCI)尿失禁的治疗效果。方法:选取46例SCI后尿失禁患者,行盆底肌电刺激及盆底肌电生物反馈治疗,在治疗前后行肛门括约肌表面肌电评估、肛门外括约肌肌力评估、膀胱容量-压力测定,并记录尿失禁次数。结果:治疗后,39例SCI尿失禁得以改善,7例SCI尿失禁改善不明显,治疗有效率为84.78%;治疗后灌注250mL时膀胱内压力较治疗前降低(P<0.01),膀胱内压力40cmH2O膀胱容量较治疗前升高(P<0.01);治疗后肛门括约肌肌力、肛门括约肌持续收缩表面肌电平均波幅较治疗前有升高(P<0.01);治疗后膀胱残余尿量较治疗前减少(P<0.01)。结论:盆底肌电刺激联合盆底肌电生物反馈治疗可以改善脊髓损伤后尿失禁,其主要通过降低膀胱内压力、提高膀胱安全容量及括约肌肌力来实现。

Analysis of Effect of Pelvic Floor Electrical Stimulation Combined with Electronic Biofeedback Therapy on Neurogenic Urinary Incontinence after SCI

Objective:To investigate the therapeutic effect of pelvic floor electrical stimulation combined with pelvic floor electrical biofeedback on spinal cord injury(SCI)incontinence.Method:46 patients w ith post-SCI incontinence w ere treated w ith pelvic floor electrical stimulation and pelvic floor electronic biofeedback therapy.Result:39 cases of SCI incontinence w as improved after treatment,7 cases of SCI incontinence improvement is not obvious,treatment effectiveness:84.78%,intravesical pressure w as reduced by infusion of 250 mL after treatment(P<0.01),the bladder pressure w as 40 cmH2 O,bladder capacity w as increased(P<0.01),anal sphincter strength and the mean amplitude of surface electromyography w as increased after treatment(P<0.01),the bladder residual urine volume w as reduced after treatment(P<0.01).Conclusion:Pelvic floor electrical stimulation combined w ith pelvic floor electronic biofeedback therapy can improve urinary incontinence after spinal cord injury.