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目的:观察电针联合膀胱功能锻炼治疗子宫颈癌术后膀胱功能障碍的临床效果和可能机制。方法:前瞻性分析两家医院2010年1月~2013年12月子宫颈癌术后患者180例,随机分为电针治疗组58例、膀胱功能锻炼组62例、联合治疗组60例,3组均于术后5天开始治疗。电针治疗组采用电针治疗。膀胱功:功能锻炼组采用膀胱功能锻炼。联合治疗组采用电针联合膀胱功能锻炼治疗。观察术后2周自主排尿成功率、膀胱症状、尿动力学检测指标。结果:联合治疗组术后2周自主排尿成功率高于电针治疗组及膀胱功能锻炼组,差异均有显著性意义(P<0.05)。联合治疗组术后2周膀胱症状均优于电针治疗组及膀胱功能锻炼组,差异均有显著性意义(P<0.05)。联合治疗组术后2周膀胱初感容积均小于电针治疗组及膀胱功能锻炼组,术后2周最大膀胱容量及最大尿流率均高于电针治疗组及膀胱功能锻炼组,差异均有显著性意义(P<0.05)。结论:电针联合膀胱功能锻炼治疗可以提高术后自主排尿成功率、减轻术后膀胱症状,机制可能为减轻逼尿肌收缩力受损。
Objective: To observe the clinical effect and possible mechanism of electroacupuncture combined with bladder functional exercise on bladder dysfunction after cervical cancer surgery. Methods: A prospective analysis of 180 patients with cervical cancer from January 2010 to December 2013 in two hospitals were randomly divided into EAA treatment group (58 cases), bladder functional exercise group (62 cases), combination therapy group (60 cases), 3 The group started treatment five days after the operation. Electroacupuncture treatment group treated with electroacupuncture. Bladder function: functional exercise group using bladder functional exercise. Combined treatment group with electro-acupuncture combined bladder function training. The success rate of spontaneous urination, bladder symptoms and urodynamics were observed 2 weeks after operation. Results: The success rate of spontaneous micturition in combination therapy group at 2 weeks after operation was significantly higher than that of EA and bladder function training group (P <0.05). The symptoms of bladder in the combination therapy group were better than those in the electroacupuncture treatment group and the bladder functional exercise group 2 weeks after operation, the difference was significant (P <0.05). The initial volume of bladder in 2 weeks after operation in combination therapy group was less than that in EA group and bladder functional exercise group. The maximum bladder volume and the maximum urinary flow rate in 2 weeks after operation were significantly higher than those in EA group and bladder function training group There was significant (P <0.05). Conclusion: Electroacupuncture plus bladder functional exercise therapy can improve the success rate of postoperative spontaneous urination and reduce postoperative bladder symptoms, the mechanism may be to reduce the detrusor contractility impaired.