在神经神经调节中对盆底运动反应进行深入分析,将其与结果联系起来
Sam Tilborghs1, Sigrid Van de Borne1, Donald Vaganée1
1Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium.
在过度活跃的膀中,神经神经调节 (SNM) 治疗的成功与盆地肌肉 (PFM) 的反应有关. 有更好的结果的患者在SNM编程期间表现出明显的PFM运动反应.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 神经学 神经学
- 生理学 生理学 生理学
背景情况:
- 圣神经调节 (SNM) 是一种治疗下尿路功能障碍的方法.
- 了解盆底肌 (PFM) 对SNM的反应对于优化治疗至关重要.
- 盆地肌肉电肌图 (EMG) 可以提供有关SNM疗效的见解.
研究的目的:
- 在SNM编程过程中描述PFM电机响应.
- 确定PFM运动反应在预测SNM治疗结果中的有用性.
- 为了将PFM EMG的发现与患有过度活性膀 (OAB) 或非阻塞性尿 (NOUR) 的患者的临床成功相关联.
主要方法:
- 对64名女性进行前性研究,这些女性接受了单方面SNM治疗OAB或NOUR.
- 在使用外部脉冲发生器时,使用多阵列探针记录PFM EMG.
- 分析包括感觉值 (ST),运动值 (MT),MT-ST比率,以及使用线性回归和线性混合模型 (LMM) 对不同刺激水平和位置的PFM振幅响应.
主要成果:
- 总体成功率为80%.
- 与非响应者相比,受访者具有明显较低的MT和MT-ST.
- PFM运动响应幅度与症状的百分比改善有显著的正相关性,特别是在次感官刺激水平.
- 响应者在增加刺激强度时表现出PFM振幅的急剧增加,在不同盆底区域有变化.
结论:
- 在PFM对SNM的运动反应和治疗疗效之间存在显著的相关性.
- 较低的MT,较低的MT-ST和较高的PFM在次感官水平的激活与成功的SNM结果有关.
- 在SNM编程期间的PFM EMG表征可以帮助预测和优化治疗交付.
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