膀胱腔内电刺激与骶神经磁刺激治疗神经源性膀胱活动低下的临床对照研究
Clinical Controlled Study of Intravesical Electrical Stimulation versus Sacral Magnetic Stimulation for the Treatment of Neurogenic Detrusor Underactivity
摘要: 目的：比较膀胱腔内电刺激(Intravesical Electrical Stimulation, IVES)与骶神经磁刺激(Sacral Magnetic Stimulation, SMS)治疗神经源性膀胱活动低下(Neurogenic Detrusor Underactivity, NDU)的临床疗效。方法：选取2023年10月至2025年6月我院收治的NDU患者共38例，采用随机数字表法分为IVES组(n = 20)和SMS组(n = 18)。IVES组有2例因泌尿系感染中途脱落，最终两组各有18例患者完成治疗。IVES组采用膀胱腔内电刺激治疗，SMS组采用骶神经磁刺激治疗，两组均治疗4周。比较两组治疗前后的初尿意(FSV)、日均单次导尿量、日均导尿次数及神经源性膀胱症状评分(NBSS)。结果：治疗前IVES组和SMS组患者的4项观察指标差异均无统计学意义(p均>0.05)。治疗后，两组患者的4项观察指标均较治疗前有显著改善(p均<0.05)。治疗后，IVES组的日均单次导尿量、日均导尿次数、NBSS评分均显著低于SMS组(p均<0.05)。在膀胱感觉功能方面，SMS组的初尿意显著低于IVES组(p = 0.002)。结论：IVES和SMS均能有效改善NDU患者的膀胱功能。IVES在改善膀胱排空功能(增加自主排尿、减少导尿依赖)和降低症状评分方面更具优势；而SMS在改善膀胱早期感觉功能(初尿意)方面表现更优。
Abstract: Objective: To compare the clinical efficacy of Intravesical Electrical Stimulation (IVES) and Sacral Magnetic Stimulation (SMS) in the treatment of Neurogenic Detrusor Underactivity (NDU). Methods: A total of 38 NDU patients admitted to our hospital from October 2023 to June 2025 were selected and randomly divided into an IVES group (n = 20) and an SMS group (n = 18) using a random number table. Two patients in the IVES group dropped out due to urinary tract infection, ultimately resulting in 18 patients in each group completing the treatment. The IVES group received intravesical electrical stimulation, while the SMS group received sacral magnetic stimulation. Both groups were treated for 4 weeks. The first sensation of bladder filling (FSV), mean single catheterization volume per day, mean number of catheterizations per day, and Neurogenic Bladder Symptom Score (NBSS) were compared between the two groups before and after treatment. Results: Before treatment, there were no statistically significant differences in the four observation indicators between the IVES and SMS groups (all p > 0.05). After treatment, all four observation indicators in both groups showed significant improvement compared to before treatment (all p < 0.05). After treatment, the mean single catheterization volume per day, mean number of catheterizations per day, and NBSS score in the IVES group were significantly lower than those in the SMS group (all p < 0.05). Regarding bladder sensory function, the first sensation of bladder filling in the SMS group was significantly lower than that in the IVES group (p = 0.002). Conclusion: Both IVES and SMS can effectively improve bladder function in patients with NDU. IVES shows greater advantages in improving bladder emptying function (increasing voluntary voiding, reducing catheter dependence) and reducing symptom scores; whereas SMS demonstrates superior efficacy in improving early bladder sensory function (first sensation of bladder filling).
文章引用：李浩, 郑雅文, 李江, 任子峤, 张永祥. 膀胱腔内电刺激与骶神经磁刺激治疗神经源性膀胱活动低下的临床对照研究[J]. 临床医学进展, 2025, 15(12): 803-811. https://doi.org/10.12677/acm.2025.15123473

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