高压氧联合电针八髎穴对脊髓损伤神经源性膀胱患者尿动力学的影响

目的：分析高压氧（HBO）联合电针八髎穴治疗对脊髓损伤神经源性膀胱患者尿动力学的影响。方法：将60例脊髓损伤神经源性膀胱患者，按随机数字表法分成对照组20例、电针组20例、联合组20例，各组均接受常规膀胱功能训练，电针组增加电针治疗，联合组增加电针治疗及高压氧治疗，分别于治疗前和治疗8周后通过尿流动力学检查及排尿日记评价3组患者的膀胱功能，并进行统计学分析。结果：治疗前3组患者的充盈期逼尿肌压(Pdet)、膀胱顺应性（BC）、最大尿流率(Qmax)、残余尿量（RV）组间差异均无统计学意义。治疗8周后，3组患者BC及Qmax明显高于治疗前(均P＜0.05)，Pdet及RV明显低于治疗前(均P＜0.05)。治疗后组间比较，电针组及联合组患者BC及Qmax明显高于对照组(均P＜0.05)，Pdet及RV显著低于对照组(均P＜0.05)；联合组BC及Qmax明显高于电针组(均P＜0.05)，Pdet及RV显著低于电针组(均P＜0.05)。治疗后，3组患者日平均排尿次数、日平均尿失禁次数均明显少于治疗前(均P＜0.05)，日平均单次尿量、下尿路症状（LUTS）评分均明显高于治疗前(均P＜0.05)。治疗后组间比较，电针组及联合组日平均排尿次数、日平均尿失禁次数均明显少于对照组(均P＜0.05)，日平均单次尿量、LUTS评分均明显高于对照组(均P＜0.05)；联合组日平均排尿次数、日平均尿失禁次数均明显少于电针组(均P＜0.05)，日平均单次尿量、LUTS评分均明显高于电针组(均P＜0.05)。结论：高压氧联合电针八髎穴治疗能有效改善脊髓损伤神经源性膀胱患者尿动力学及排尿功能，提高生存质量，该方法值得临床推广。

Effects of hyperbaric oxygen combined with electro-acupuncture at Baliao acupoint on the urodynamics in patients with neurogenic bladder after spinal cord injury

Objective: To analyze the effects of hyperbaric oxygen (HBO) combined with electro-acupuncture at Baliao acupoint on the urodynamics in patients with neurogenic bladder after spinal cord injury (SCI). Methods: A total of 60 patients with neurogenic bladder after SCI were randomly divided into the control group (n=20), electro-acupuncture group (n=20) and the combination treatment group (n=20). Each group received routine bladder training. The electro-acupuncture group was given electro-acupuncture therapy additionally, and the combination group was subjected to electro-acupuncture therapy and hyperbaric oxygen therapy additionally. The bladder urination was evaluated by urodynamic test and the bladder diary before and after 8 weeks of treatment. Results: There was no significant difference among the three groups in detrusor pressure at filling time, bladder compliance, maximum urine flow rate and residual urine volume before the treatment. After 8 weeks of treatment, the above indexes in the electro-acupuncture group were significantly better than those in control group. The bladder compliance and maximum urine flow rate in the combination group were significantly higher than those in the electro-acupuncture group. The detrusor pressure at filling time and the residual urine volume in the combination group were significantly reduced as compared with those in the electro-acupuncture group. After treatment, the average daily urination frequency and average daily frequency of urinary incontinence in the three groups were significantly decreased, the average daily single urine output was significantly enhanced as compared with those before treatment (P<0.05), and the above indexes in combination group were significantly better than those in control group and electro-acupunc-ture group (P<0.05). Conclusion: Hyperbaric oxygen combined with electro-acupuncture at Baliao acupoint can effectively improve the urodynamics and urination function of patients with neurogenic bladder after SCI and enhance the quality of life. This method is worthy of clinical promotion.