【摘要】 目的 评估骶神经调控（SNM）治疗功能性盆底功能障碍性疾病的有效性和安全性。方法 回顾性分析甘肃省人民医院2015年12月-2020年7月收治的15例接受SNM体验治疗盆底功能障碍性排尿、排便障碍患者临床资料。评估患者术前、Ⅰ期体验性电极植入及Ⅱ期永久刺激器植入后72 h排尿日记、尿急程度评分、残余尿量、VAS评分和O’leary-Sant评分及Wexner便秘指数评分。结果 15例患者体验期治疗平均3.5周。体验期末7例患者自觉症状及观察指标至少1项获得> 50%的改善；2例顽固性膀胱过度活动症患者尿急程度评分、急迫性尿失禁次数、24 h排尿次数均较术前明显改善（P <0.05）;3例难治性盆腔疼痛/膀胱疼痛综合征/间质性膀胱炎患者平均每次尿量、单次最大尿量、O’leary-Sant评分及VAS评分均较术前明显改善（P <0.05）;2例神经源性膀胱患者，2例便秘患者Wexner指数评分、24 h排尿次数明显改善（P<0.05）。其他8例患者因体验治疗后症状改善不佳或主观评分较低或经济等其他原因拒绝行Ⅱ期手术。结论 SNM是治疗盆底功能障碍性排尿、排便障碍患者安全、有效、可选择的微创手段，需要严密随访，不定时调整参数及配合相应其他治疗。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of sacral neuroregulation(SNM) in treating functional pelvic floor dysfunction diseases. Methods The clinical data of 15 patients undergoing SNM testing therapy from from December 2015 to July 2020 in Gansu Provincial Hospital were reviewed. Voiding diary of 72 h,average degree of urgency, post-void residual volume(PVR), VAS score, O’leary-Sant score, Wexner score preoperation and during the course of stageⅠand stage Ⅱ electrode implantation surgery and follow-up were recorded. Results The average test time was 3.5 weeks of 15 patients. 7 cases had an improvement of more than 50% in at least one symptom. 2 cases with refractory overactive bladder patients in the average degree of urgency, the number of urine leakage and average number of voids/24 h were improved(P < 0.05). 3 cases of refractory pelvic pain/bladder pain syndrome/interstitial cystitis patients in an average number of voids, single marimum urme volume, O’leary-Sant score and VAS score were inproved(P < 0.05). 2 neurogenic bladder patients, 2 cases of constipation with the Wexner score and average number of voids/24 h were inproved(P <0.05). Other 7 neurogenic bladder patients and 1 refractory overactire bladder patient were performed electrode removal under local anesthesia for reasons due to poor test effect or economics. Conclusion SNM is a safe, effective and optional minimally invasive means to treat patients with functional pelvic floor disorders.Patients need regular follow-up and programming, including coordination with other corresponding treatments.更多还原