摘要
目的:探究双侧骶神经调节术(SNM)治疗儿童下尿路功能障碍(LUTD)的疗效及对尿动力学的影响。方法:入选2020年6月至2022年6月我院LUTD患儿98例,随机数表法分为研究组和对照组,每组49例。对照组采用膀胱功能训练+骶神经根磁刺激治疗,研究组采用双侧SNM治疗。比较两组治疗效果、治疗前后临床症状、治疗前及治疗后1个月、3个月、6个月尿动力学[膀胱最大容量、逼尿肌漏尿点压(DLPP)、膀胱顺应性]、自由尿流率、国际下尿路症状(LUTS)评分、生活质量。结果:研究组治疗总有效率85.71%,高于对照组67.35%,差异具有统计学意义(P<0.05)。治疗后研究组排尿次数、导尿次数、导尿量少于对照组,排尿量多于对照组(P<0.05)。研究组治疗后1个月、3个月、6个月膀胱最大容量、膀胱顺应性、平均尿流率、最大尿流率大于对照组,尿流时间短于对照组(P<0.05)。研究组治疗后1个月、3个月、6个月LUTS评分低于对照组,PedsQLTM 3.0评分高于对照组(P<0.05)。结论:双侧SNM治疗儿童LUTD效果显著,能改善患儿尿流动力学,减轻临床症状,提高生活质量。
Objective:To investigate the effect of bilateral sacral neuromodulation(SNM)in the treatment of lower urinary tract dysfunction(LUTD)in children and its impact on urodynamic parameters.Methods:98 cases of LUTD children in our hospital from June 2020 to June 2022 were selected and randomly divided into control and research group,49 cases in each group.The control group was treated with bladder function training+magnetic stimulation of sacral nerve roots,and the study group was treated with bilateral SNM.Treatment effect,clinical symptoms before and after treatment,urodynamic indexes[maximum bladder volume,detrusor leaky point pressure(DLPP),bladder compliance],free urinary flow rate,international lower urinary tract symptoms(LUTS)score and quality of life of the two groups were compared before treatment and 1,3 and 6 months after treatment.Results:The total effective rate of the study group(85.71%)was higher than that of the control group(67.35%)(P<0.05).After treatment,the frequency of urination,the frequency of catheterization and the volume of catheterization in the study group were less than those in the control group,and the volume of urination was more than that of the control group(P<0.05).The maximum bladder volume,bladder compliance,average urine flow rate and maximum urine flow rate were higher in the study group than that of the control group at 1 month,3 months and 6 months after treatment,while the urine flow time was shorter than that of the control group(P<0.05).LUTS score of the study group was lower than that of the control group at 1 month,3 months and 6 months after treatment,and PedsQLTM 3.0 score was higher than that of the control group(P<0.05).Conclusion:Bilateral SNM is effective in the treatment of LUTD in children,improving urodynamic parameters,alleviating clinical symptoms,reduce clinical symptoms and improve quality of life.
作者
尤龙
张晔
张殷
You Long;Zhang Ye;Zhang Yin(Department of Urology,Anhui Children's Hospital,Hefei 230000,China)
出处
《微创泌尿外科杂志》
2023年第5期322-328,共7页
Journal of Minimally Invasive Urology
基金
安徽省卫生厅医药科研计划项目(12925KJ20200241)
关键词
下尿路症状
骶神经调节
膀胱
尿动力学
lower urinary tract symptoms
sacral neuromodulation
bladder
urodynamics
