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摘要: 目的:探讨骶神经调控术(SNM)中不同疾病的参数设置对疗效的影响评价。方法:回顾性分析我院2016年3月~2018年12月117例接受SNM第二阶段永久刺激器植入术患者的临床资料。按疾病种类将患者分为四组,即膀胱过度活动症组(n=9)、盆腔疼痛组(n=31)、神经源性膀胱组(n=66)及排尿困难组(n=11)。统计分析四组患者年龄、性别、电极放置情况、刺激模式及第一阶段测试中最优化的电压、脉宽、频率等参数。结果:膀胱过度活动症组、盆腔疼痛组、神经源性膀胱组和排尿困难组患者年龄分别为(51.11±14.09)岁、(57.62±14.13)岁、(53.36±22.42)岁和(55.09±19.42)岁;膀胱过度活动症组男1例,女8例;盆腔疼痛组男13例,女18例;神经源性膀胱组男34例,女32例;排尿困难组男7例,女4例。第一阶段最优化的膀胱过度活动症组、盆腔疼痛组、神经源性膀胱组和排尿困难组电压分别为(1.91±1.56) V、(1.22±0.54) V、(1.47±0.81) V和(1.38±0.76) V,四组比较差异无统计学意义(P>0.05);植入后脉宽分别为(262.50±81.37)μs、(270.00±68.68)μs、(286.15±65.83)μs和(265.00±77.78)μs,四组比较差异无统计学意义(P>0.05);植入后频率分别为(11.87±5.41) Hz、(19.20±13.10) Hz、(29.79±9.51) Hz和(20.50±10.11) Hz,四组比较差异有统计学意义(P<0.01)。结论:神经源性膀胱患者在频率方面明显高于膀胱过度活动症、盆腔疼痛及排尿困难患者,四组患者在电压及脉宽方面并无显著差异。今后SNM测试中可适当增加神经源性膀胱患者的频率,使患者能达到更好的疗效。Abstract: Objective: To evaluate the effect of parameter setting with sacral neuromodulation in different diseases. Method: A retrospective analysis was performed on the information of patients who received the Phase Ⅱ permanent sacral neuromodulation from March 2016 to December 2018 in the south hospital of Renji, affiliated to Shanghai Jiao Tong University School of Medicine. A total of 117 patients were enrolled in this study, which were divided into four groups according to the type of disease: 9 patients in the overactive bladder group, 31 patients in the pelvic pain group, 66 patients in the neurogenic bladder group, and 11 patients with dysuria group. The age, gender, electrode placement, stimulation mode, voltage, pulse width, frequency and other parameters of the patients in the four groups were statistically analyzed. Result: The age of patients in the four groups were (51.11±14.09) years old, (57.62±14.13) years old, (53.36±22.42) years old and (55.09±19.42) years old, respectively. There were 1 male and 8 females in the overactive bladder group. The pelvic pain group included 13 males and 18 females. Neurogenic bladder group included 34 males and 32 females. The dysuria group included 7 males and 4 females. The voltage of the four groups were (1.91±1.56) V, (1.22±0.54) V, (1.47±0.81) V and (1.38±0.76) V, respectively (P>0.05). After implantation, there was no statistically significant difference among the post-implantation overactive bladder group (262.50±81.37) μs, the pelvic pain group (270.00±68.68) μs, the neurogenic bladder group (286.15±65.83) μs and the dysuria group (265.00±77.78) μs. The frequencies of the four groups were (11.87±5.41) Hz, (19.20±13.10) Hz, (29.79±9.51) Hz, (20.50±10.11) Hz, respectively (P<0.01).Conclusion: Combined with the analysis of the results, the startup frequency of neurogenic bladder patients was significantly higher than that of the other overactive bladder group, pelvic pain group and the dysuria group. There was no significant difference in voltage or pulse width among the four groups. Therefore, in the future, the frequency of neurogenic bladder patients can be appropriately increased in sacral neuromodulation test, so that patients can achieve better efficacy.
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Key words:
- overactive bladder /
- neurogenic bladder /
- pelvic pain /
- dysuria /
- neuromodulation
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