Abstract: 【Abstract】〓Objective〓To discuss the value of nerve root stimulation system in the treatment of spinal cord injury caused by neurogenic bladder dysfunction (NBD). Methods〓Seventy-two patients with NBD were selected in our Hospitals. All patients were divided into control group (n=24) and stimulating group (n=48), two groups of patients were given oral tolterodain (2 mg/day) treatment. The stimulating group again divided into sacral nerve stimulation (SNS group, n=24) group and neuromuscular electrical stimulation (NES group, n=24) group, and got three-month follow-up. The urine flow mechanics, urethral pressure and average daily number of urination were analyzed. Results〓The residual urine volume and maximum bladder capacity in NES group were significantly better than that of SNS group (P<0.017), and residual urine volume and maximum bladder capacity in SNS group were significantly better than that of control group (P<0.017). After treatment for 60 days, the detrusor pressure level and the average urination frequency in NES group were significantly improved than in control group (P<0.017), and after treatment for 120 days, the effect in NES group were better than and control group and SNS group (P<0.017). Conclusion〓Nerve root stimulation treatment can improve bladder function of the patients with NBD.

Key words: Nerve root stimulation system, Spinal cord injury, Neurogenic bladder dysfunction

摘要： 【摘要】〓目的〓探讨神经根刺激器在治疗脊髓损伤所致神经原性膀胱功能障碍(NBD)的应用价值。方法〓选取2009年3月至2013年5月期间我院确诊治疗的脊髓损伤所致NBD患者72例,分刺激组和对照组,两组患者均给予每天2次口服托特罗定(2 mg/次)治疗,刺激组患者在此基础上给予神经根刺激治疗,其中刺激组依据治疗方法又分为骶神经电刺激(SNS)治疗组和神经肌肉电刺激(NES)治疗组,对所有患者进行为期3个月的随访,观察患者尿流动力学、尿道压力和日均排尿次数。结果〓在尿流动力学方面,NES组残余尿量和最大膀胱容量明显优于SNS组(P<0.017),而SNS组残余尿量与最大膀胱容量明显优于对照组(P<0.017);在逼尿肌压力水平与日均排尿次数方面,治疗后60 d,NES组明显优于对照组(P<0.017);治疗后120 d,NES组明显优于SNS组与对照组,SNS组明显优于对照组(P<0.017)。结论〓神经根刺激治疗有利于改善脊髓损伤所致NBD患者膀胱功能。

关键词: 神经根刺激器, 脊髓损伤, 神经原性膀胱功能障碍