Feng Zichao,Wang Zhan,Wen Yibo,et al.Efficacy of transcutaneous tibial electrical nerve stimulation on bladder function in children with overactive bladder[J].Journal of Clinical Pediatric Surgery,2026,(07):616-620.[doi:10.3760/cma.j.cn101785-20260331-00149]
经皮胫神经电刺激对膀胱过度活动症患儿膀胱功能的影响
- Title:
- Efficacy of transcutaneous tibial electrical nerve stimulation on bladder function in children with overactive bladder
- Keywords:
- Percutaneous Electrical Nerve Stimulation; Tibial Nerve; Child; Overactive Bladder; Urodynamic Study; Detrusor Overactivity
- 摘要:
- 目的 采用膀胱压力-流率测定(pressure-flow study,PFS)、症状量表评分评估经皮胫神经电刺激(transcutaneous tibial nerve stimulation,TTNS)对膀胱过度活动症(overactive bladder,OAB)患儿膀胱功能的影响。方法 本研究为多中心、自身前后对照研究。选取2024年9月1日至2025年12月31日郑州大学第一附属医院、福建儿童医院、东莞儿童医院符合纳排标准的OAB患儿28例,签署知情同意后先行PFS检查,确认存在逼尿肌过度活动(detrusor overactivity,DO)或膀胱低顺应性,随即行30 min TTNS治疗,治疗后立即复查PFS,对比两次尿动力学参数的即时变化。选取TTNS后尿动力学参数显著改善的18例患儿,行周期性TTNS治疗(每次30 min,每周3次),治疗2个月后采用膀胱过度活动症症状评分(overactive bladder symptom score,OABSS)、尿失禁生活质量问卷(incontinence quality of life questionnaire,I-QOL)评估疗效。结果 与治疗前相比,TTNS干预后患儿最大DO压力由(59.86±27.71)cmH2O降低至(43.04±18.67)cmH2O,膀胱容量比值(实测膀胱容量/预期膀胱容量)由(0.56±0.19)提高至(0.66±0.15),首次逼尿肌非自主收缩时膀胱容量由(52.86±31.48)mL提高至(72.64±36.52)mL,差异均有统计学意义(P<0.05);膀胱顺应性、残余尿量无显著变化(P>0.05)。周期性TTNS治疗2个月后,患儿白天排尿次数评分由(1.61±0.50)降低至(1.17±0.51)、尿急严重程度评分由(3.72±0.75)降低至(2.78±1.17)、急迫性尿失禁次数评分由(2.78±0.88)降低至(2.17±0.71)、OABSS总分由(8.56±1.89)降低至(6.33±1.65);I-QOL评分由(39.78±9.30)升高至(50.78±16.78),差异均有统计学意义(P<0.05);夜间排尿次数评分无显著变化(P>0.05)。结论 TTNS对OAB患儿具有即时改善作用,可增加膀胱容量与首次膀胱感觉容量,降低伴DO的OAB患儿DO发生率;即时有效者经长期规律治疗可减轻OAB症状、提高生活质量。
- Abstract:
- Objective To evaluate the efficacy of transcutaneous tibial electrical nerve stimulation (TTNS) on bladder function in children with overactive bladder (OAB) using pressure-flow study (PFS) parameters and symptom scale scores. Methods For this multicenter,self-controlled before-after study,28 OAB children fulfilling the inclusion criteria were recruited from First Affiliated Hospital of Zhengzhou University,Fujian Children’s Hospital,and Dongguan Children’s Hospital between September 1,2024 and December 31,2025.After informed consent,all participants underwent PFS to confirm the presence of detrusor overactivity (DO) or low bladder compliance,followed immediately by a 30-minute TTNS session.PFS was repeated right after treatment and immediate changes in urodynamic parameters were compared.Eighteen children showing significant improvements in urodynamic parameters after a single TTNS session received periodic TTNS (30 minutes per session,three times per week) for 2 months.Treatment efficacy was assessed by Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life Questionnaire (I-QOL).Results As compared with pre-treatment values,maximum DO pressure dropped from (59.86±27.71) to (43.04±18.67) cmH2O,bladder capacity ratio (measured/expected bladder capacity) spiked from (0.56±0.19) to (0.66±0.15) and bladder capacity at initial involuntary detrusor contraction expanded from (52.86±31.48) to (72.64±36.52) ml immediately after TTNS; all differences were statistically significant (P<0.05).Bladder compliance and post-void residual urine volume showed no marked changes (P>0.05).After 2-month periodic TTNS,daytime frequency score decreased from (1.61±0.50) to (1.17±0.51),urgency severity score from (3.72±0.75) to (2.78±1.17),urge urinary incontinence score from (2.78±0.88) to (2.17±0.71) and total OABSS from (8.56±1.89) to (6.33±1.65); I-QOL score jumped from (39.78±9.30) to (50.78±16.78).All these changes were statistically significant (P<0.05).Nighttime frequency score did not change significantly (P>0.05).Conclusion TTNS provides an immediate benefit for in OAB children through expanding bladder capacity and bladder capacity at initial sensation and lowering the incidence of DO in OAB children.Immediate responders may achieve an alleviation of OAB symptoms and improved quality-of-life with long-term regular treatment.
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备注/Memo
收稿日期:2026-3-31。
基金项目:国家自然科学基金(82470807)
通讯作者:文建国,Email:jgwen@zzu.edu.cn