李震东+吕婷婷+吕坚伟+蒋晨+傅琦博

摘 要 目的：评价电针神经刺激疗法治疗前列腺癌根治术后尿失禁的临床疗效。方法：选择2010年9月—2015年8月前列腺癌根治术后尿失禁患者32例，予电针神经刺激疗法治疗，取穴“骶四穴”，治疗时间60 min/次，每周3次，疗程1个月。记录治疗前和治疗结束时的症状积分、盆底肌能力评分并评定疗效。结果：患者症状评分从治疗前的（17.36±3.53）分降至治疗后的（8.79±2.65）分，差异有统计学意义（P<0.01）；盆底肌肉功能评分从治疗前的（47.21±10.38）分上升至（77.72±9.21）分，差异有统计学意义（P<0.01）。治疗结束时临床有效率为81.25%（26/32）。结论：电针神经刺激疗法治疗前列腺癌根治术后尿失禁效果良好，且无明显不良反应，可作为前列腺癌根治术后尿失禁的首选物理治疗方法。

关键词 尿失禁 前列腺癌根治术 电针神经刺激

中图分类号：R737.25/R246.9 文献标志码：A 文章编号：1006-1533（2016）14-0007-03

Effect of electro-acupuncture nerve stimulation in treatment of patients with postoperative urinary incontinence

LI Zhendong1， LV Tingting2， LV Jianwei1， JIANG Chen1， FU Qibo1，（1. Department of Urology， South Renji Hospital affiliated to Shanghai Jiao Tong University， Shanghai 201112， China； 2. University of

Shanghai Traditional Chinese Medicine， Shanghai 201203， China）

ABSTRACT Objective： To inve stigate the clinical effect of electro-acupuncture nerve stimulation in the treatment of patients with urinary incontinence after radical prostatectomy. Methods： Thirty-two patients with postoperative urinary incontinence were enrolled from Sep. 2010 to Aug. 2015 and received electro-acupuncture nerve stimulation therapy. Four abdominal acu-points were selected and acupunctured for 60 minutes once， 3 times a week for one month. The symptom score and pelvic floor muscle ability score were recorded before and after treatment and the clinical effects were assessed. Results： The symptom score was decreased from 17.36±3.53 before treatment to 8.79±2.65 after treatment（ P<0.01） . The pelvic floor muscle ability score was increased from 47.21±10.38 before treatment to 77.72±9.21 after treatment with statistical difference（ P<0.01） .The clinical efficacy was 81.25%（26/32）after treatment. Conclusion： Electro-acupuncture nerve stimulation therapy is effective in the treatment of patients with post-radical prostatectomy urinary incontinence and no obvious adverse reaction was found. It can be used as the first choice in the treatment of patients with postoperative urinary incontinence.

KEY WORDS urinary incontinence； radical prostatectomy； electro-acupuncture nerve stimulation

随着我国人口老龄化，前列腺癌发病率呈逐年升高趋势。前列腺癌根治术是局限性前列腺癌的标准治疗方法，尿失禁是前列腺癌根治术后最常见的并发症，发生率为0.3%～65.6%[1]，严重影响患者的生活质量和心理健康。本文报道仁济医院盆底中心采用电针疗法治疗前列腺癌根治术后尿失禁患者32例，效果良好。

1 资料与方法

1.1 一般资料

选择2010年9月—2015年8月上海交通大学附属仁济医院尿失禁及盆底重建诊治中心收治的前列腺癌根治术后尿失禁患者32例，均为术后2～3周拔出导尿管后出现不同程度尿失禁，护垫实验阳性，符合前列腺癌术后尿失禁症状。患者年龄51～79岁，中位年龄68岁；尿失禁病程2～24个月，平均17.5个月。Ⅲ度尿失禁（依靠阴茎夹控制尿液）8例；Ⅱ度尿失禁（夜间或仰卧位可控制尿液，坐位或直立行走则尿失禁）19例；Ⅰ度尿失禁（坐位或直立行走可控制，大笑、运动等增加腹压时尿失禁）5例。排除标准：①膀胱功能障碍的神经肌肉、内分泌等系统疾病患者；……