经皮电刺激治疗脊髓损伤后神经源性膀胱功能障碍的疗效：随机对照试验的荟萃分析。
Transcutaneous Electrical Stimulation for Neurogenic Bladder Dysfunction Following Spinal Cord Injury: Meta-Analysis of Randomized Controlled Trials.
机构信息
Department of Anatomy and Medical Imaging, School of Medical Sciences, Faculty of Medical and Health Sciences and the Centre for Brain Research, University of Auckland, Auckland, New Zealand.
Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
出版信息
Neuromodulation. 2021 Oct;24(7):1237-1246. doi: 10.1111/ner.13459. Epub 2021 May 19.
OBJECTIVES
To assess the efficacy of transcutaneous electrical nerve stimulation (TENS) for neurogenic bladder dysfunction secondary to spinal cord injury (SCI).
MATERIALS AND METHODS
A systematic search of MEDLINE, EMBASE, Web of Science, Scopus, and Cochrane libraries up to February 2021 was performed using PRISMA methodology. All randomized controlled trials (RCTs) that studied TENS for neurogenic bladder in a SCI population were included. The primary outcomes of interest were maximum cystometric capacity (MCC) and maximum detrusor pressure (Pdet). Meta-analysis was conducted with RevMan v5.3.
RESULTS
Six RCTs involving 353 participants were included. Meta-analysis showed that TENS significantly increased MCC (standardized mean difference 1.11, 95% confidence interval [CI] 0.08-2.14, p = 0.03, I = 54%) in acute SCI. No benefits were seen for maximum Pdet. TENS was associated with no major adverse events.
CONCLUSIONS
TENS may be an effective, safe intervention for neurogenic bladder dysfunction following SCI. Further studies are essential to confirm these results and more work is required to determine optimal stimulation parameters and duration of the treatment.
目的
评估经皮神经电刺激（TENS）治疗脊髓损伤（SCI）后神经源性膀胱功能障碍的疗效。
材料与方法
采用 PRISMA 方法对截至 2021 年 2 月的 MEDLINE、EMBASE、Web of Science、Scopus 和 Cochrane 图书馆进行系统检索。纳入所有研究 TENS 治疗 SCI 人群神经源性膀胱的随机对照试验（RCT）。主要观察指标为最大膀胱容量（MCC）和最大逼尿肌压力（Pdet）。采用 RevMan v5.3 进行荟萃分析。
结果
纳入 6 项 RCT，共 353 名参与者。荟萃分析显示，TENS 可显著增加急性 SCI 患者的 MCC（标准化均数差 1.11，95%置信区间 [CI] 0.08-2.14，p = 0.03，I ² = 54%）。但对最大 Pdet 无明显获益。TENS 无严重不良事件。
结论
TENS 可能是 SCI 后神经源性膀胱功能障碍的一种有效、安全的干预措施。需要进一步研究来证实这些结果，还需要更多的工作来确定最佳的刺激参数和治疗持续时间。
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