摘要
Abstract
Objective:To observe the effect of percutaneous tibial nerve stimulation(PTNS)combined with stepwise bladder training on urodynamic parameters and quality of life in patients with neurogenic bladder(NB)after spinal cord injury.Method:A total of 68 patients with NB after spinal cord injury admitted to Nanjing Yincheng Rehabilitation Hospital from February 2023 to May 2025 were selected as study subjects.They were divided into two groups using a random number table method,with 34 cases in each group.The training group received stepwise bladder training,while the electrical stimulation group underwent PTNS in addition to the training.The two groups were compared in terms of urination status,urodynamic[maximum flow rate(Qmax),residual urine volume(RUV),maximum detrusor pressure(Pdet-max)],pelvic floor electromyography values(at rest,fast contraction,tension contraction,and endurance contraction stages),neurogenic bladder symptom score(NBSS),and urinary symptom distress scale(USDS)score.Result:Compared with the training group,the electrical stimulation group showed significantly fewer daily voiding episodes and daily incontinence episodes,as well as larger single voiding volume after 1 month of treatment(P<0.05).In comparison with the training group,the electrical stimulation group exhibited less RUV,faster Qmax,and higher Pdet-max after 1 month of treatment(P<0.05).The electrical stimulation group demonstrated higher pelvic floor electromyography values during endurance contraction,fast contraction,tension contraction,and resting stages after 1 month of treatment compared to the training group(P<0.05).Compared with the training group,the electrical stimulation group had significantly lower scores for incontinence,storage and leakage,and outcome of NBSS after 1 month of treatment(P<0.05).No statistically significant difference was observed in USDS scores between the two groups at 1 month after treatment(P>0.05).Conclusion:The application of PTNS combined with stepwise bladder training in patients with NB after spinal cord injury is beneficial for alleviating symptoms,improving urodynamic,enhancing pelvic floor muscle function,and restoring urinary function.关键词
脊髓损伤后神经源性膀胱/经皮胫神经电刺激/阶梯式膀胱训练/尿流动力学参数/生活质量Key words
Neurogenic bladder after spinal cord injury/Percutaneous tibial nerve stimulation/Stepwise bladder training/Urodynamic parameters/Quality of life分类
医药卫生
