Zhang Yong-Bing, Cheng Yan-Na
Department of Neurosurgery, Yan'an People's Hospital.
Department of Nephrology, The Affiliated Hospital of Yan'an University, Yan'an, China.
Medicine (Baltimore). 2019 Jan;98(2):e14106. doi: 10.1097/MD.0000000000014106.
This study aimed to evaluate the effectiveness of neuromuscular electrical stimulation (NMES) therapy for chronic urinary retention (CUR) following traumatic brain injury (TBI).
This 2-arm randomized controlled trial (RCT) enrolled 86 eligible patients with CUR following TBI. All included patients were randomly allocated to a treatment group (n = 43) or a sham group (n = 43). The administration of NMES or sham NMES, as intervention, was performed for an 8-week period treatment, and 4-week period follow-up. In addition, all subjects were required to undergo indwelling urinary catheter throughout the study period. The primary outcome was assessed by the post-voiding residual urine volume (PV-VRU). The secondary outcomes were evaluated by the voided volume, maximum urinary flow rate (Qmax), and quality of life, as assessed by Barthel Index (BI) scale. In addition, adverse events were also recorded during the study period. All primary and secondary outcomes were measured at baseline, at the end of 8-week treatment, and 4-week follow-up.
At the end of 8-week treatment, the patients in the treatment group did not achieve better outcomes in PV-VRU (P = .66), voided volume (P = .59), Qmax (P = .53), and BI scores (P = .67), than patients in the control group. At the end of 4-week follow-up, there were also no significant differences regarding the PV-VRU (P = .42), voided volume (P = .71), Qmax (P = .24), and BI scores (P = .75) between 2 groups. No adverse events occurred in either group.
In summary, the findings of this study showed that NMES therapy may not benefit patients with CUR following TBI.
本研究旨在评估神经肌肉电刺激(NMES)疗法对创伤性脑损伤(TBI)后慢性尿潴留(CUR)的有效性。
这项双臂随机对照试验(RCT)纳入了86例符合条件的TBI后CUR患者。所有纳入患者被随机分配至治疗组(n = 43)或假治疗组(n = 43)。作为干预措施,进行为期8周的NMES或假NMES治疗,并进行为期4周的随访。此外,所有受试者在整个研究期间都需要留置导尿管。主要结局通过排尿后残余尿量(PV-VRU)进行评估。次要结局通过排尿量、最大尿流率(Qmax)以及通过Barthel指数(BI)量表评估的生活质量进行评估。此外,在研究期间还记录了不良事件。所有主要和次要结局均在基线、8周治疗结束时和4周随访时进行测量。
在8周治疗结束时,治疗组患者在PV-VRU(P = 0.66)、排尿量(P = 0.59)、Qmax(P = 0.53)和BI评分(P = 0.67)方面的结局并不优于对照组患者。在4周随访结束时,两组之间在PV-VRU(P = 0.42)、排尿量(P = 0.71)、Qmax(P = 0.24)和BI评分(P = 0.75)方面也没有显著差异。两组均未发生不良事件。
总之,本研究结果表明,NMES疗法可能对TBI后CUR患者没有益处。