上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (4): 396-.doi: 10.3969/j.issn.1674-8115.2012.04.005

• 专题报道（排尿功能障碍及盆底重建） • 上一篇    下一篇

34例慢性盆底功能障碍骶神经调节治疗的测试结果观察

卫中庆1, 沈百欣1, 丁留成1, 易超然2, 丁曙晴3, 于洪波4, 文 伟5, 孙则禹2, Philip Van Kerrebroeck6   

  1. 1.南京医科大学第二附属医院泌尿外科, 南京 210011； 2.南京大学医学院附属鼓楼医院泌尿外科, 南京 210008； 3.南京中医药大学第三附属医院肛肠外科, 南京 210002； 4.南京医科大学明基医院泌尿外科, 南京 210019； 5.上海交通大学附属第一人民医院泌尿外科, 上海 200080； 6.马斯特里赫特大学医院泌尿外科, 荷兰马斯特里赫特 5800
  • 出版日期:2012-04-28 发布日期:2012-04-27
  • 作者简介:卫中庆（1963—）, 男, 主任医师, 博士；电子信箱: weizq1@163.com。
  • 基金资助:

    江苏省科技厅国际合作项目（BZ2005008）；国家留学人员择优基金（SRL05034）

Test results of sacral neuromodulation in 34 patients with chronic pelvic floor dysfunction

WEI Zhong-qing1, SHEN Bai-xin1, DING Liu-cheng1, YI Chao-ran2, DING Shu-qing3, YU Hong-bo4, WEN Wei5, SUN Ze-yu2, Philip Van Kerrebroeck6   

  1. 1.Department of Urology, the Second Hospital Affiliated to Nanjing Medical University, Nanjing 210011, China； 2.Department of Urology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China； 3.Department of Anus &|Intestine Surgery, the Third Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, China； 4.Department of Urology, BenQ Hospital, Nanjing Medical University, Nanjing 210019, China； 5.Department of Urology, the First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China； 6.Department of Urology, University Hospital Maastricht, Maastricht 5800, Holland
  • Online:2012-04-28 Published:2012-04-27
  • Supported by:

    International Cooperation Project of Department of Science and Technology of Jiangsu Province, BZ2005008；National Fundation for Overseas Talents of China, SRL05034

PDF (PC)

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摘要：

目的 探讨骶神经调节测试评估阶段临时电极及自固定倒齿状（Tined Lead）电极的疗效及安全性。方法 将34例慢性盆底功能障碍患者按电极置入方法不同分为临时电极组（n=16）和自固定Tined Lead电极组（n=18），并进行术后两种电极临时刺激测试。在测试期记录排尿排便日记，进行相关尿动力学参数测定。结果 急迫性尿失禁患者中，有43%症状改善；尿频尿急患者中有35%症状改善；10%的急迫性尿失禁/尿频尿急患者治愈。临时电极组患者排尿排便自我感觉的改善率为32.2%，自固定Tined Lead电极组为38.2%，两组差异有统计学意义（P＜0.05）。盆底疼痛综合征/间质性膀胱炎患者疼痛及排尿容量改善率在临时电极组与自固定Tined Lead电极组间的差异无统计学意义（P>0.05）。临时电极组有4例发生电极移位，自固定Tined Lead组有1例发生电极移位。结论 骶神经调节是一种创伤小、安全、有效的治疗慢性盆底功能障碍的方法, 采用Tined Lead电极可防止电极移位，提高测试的成功率及疗效。

关键词: 骶神经调节, 测试, 慢性盆底功能障碍

Abstract:

Objective To investigate the therapeutic effect and safety of temporary electrode and Tined Lead electrode in sacral neuromodulation evaluation. Methods Thirty-four patients with chronic pelvic floor dysfunction were divided into temporary electrode group (n=16) and Tined Lead electrode group (n=18), and temporary stimulation tests were performed after electrode placement. The conditions of voiding and defecation were recorded every day, and related urodynamic parameters were measured. Results The symptoms improved in 43% patients with urgent incontinence and 35% patients with urinary frequency and urgency, and 10% patients with urgent incontinence or urinary frequency and urgency were cured. There were significant differences in the rates of self-perceived improvement of voiding and defecation between temporary electrode group and Tined Lead electrode group (32.2% vs 38.2%, P＜0.05). There was no significant difference in the rates of improvement of pain and voiding volume in patients with pelvic floor pain syndrome and interstitial cystitis between two groups (P>0.05). Electrode shift took place in 4 patients in temporary electrode group and in 1 patient in Tined Lead electrode group. Conclusion Sacral neuromodulation is a safe, minimally invasive and effective method for treatment of chronic pelvic floor dysfunction, and Tined Lead electrode may prevent the electrode shift, increase the rate of success, and improve the therapeutic effect.

Key words: sacral nerve neuromodulation, measurement, chronic pelvic floor dysfunction