生物反馈治疗膀胱过度活动症的疗效及影响因素分析
刁宏旺1,李守林2,陈进军2,邓志梅2,王 浩2,姜俊海2,刘晓东2,徐雅南2,张 柳2,徐其涛2,周 蔚2,文建国3

1.汕头大学深圳儿科临床学院(广东省深圳市,518038); 2.深圳市儿童医院泌尿外科(广东省深圳市,518038); 3.郑州大学第一附属医院小儿尿动力学中心和河南省高等学校临床医学重点学科开放实验室(河南省郑州市,450052)

膀胱过度活动症; 生物反馈; Logistic模型; 儿童

Analysis of influencing factors for biofeedback efficacy in the treatment of pediatric overactive bladder.
Diao Hongwang1,Li Shoulin2,Chen Jinjun2,Deng Zhimei2,Wang Hao2,Jiang Junhai2,Liu Xiaodong2,Xu Yanan2,Zhang Liu2,Xu Qitao2,Zhou Wei2,Wen Jianguo3.

1.Shenzhen Hospital of Pediatrics,Shantou University,Shenzhen 518038,China; 2.Deparment of Urinary Surgery,Municipal Children's Hospital,Shenzhen 518038,China; 3.Department of Urodynamic Center & Urology,First Affiliated Hospital,Zhengzhou University; Open and Key Laboratory of Clinical Medicine at Henan Universities,Zhengzhou 450052, China.Corresponding author:Li Shoulin,Email:lishoulinsz@126.com.

Overactive Bladder; Biofeedback; Logistic Models; Child

DOI: 10.3969/j.issn.1671— 6353.2018.07.005

备注

目的 探讨影响膀胱过度活动症(overactive bladder,OAB)生物反馈治疗临床疗效的相关因素。方法 收集本院2016年1月至2017年6月收治的205例实施生物反馈联合电刺激治疗的OAB患儿临床资料,对治疗有效组195例和无效组10例进行回顾性分析。分别对两组患儿治疗相关因素进行单因素和多因素Logistic回归分析。相关因素包括患儿年龄、性别、电刺激电流最大值、治疗频率、联合药物(奥昔布宁)、合并尿失禁情况等。结果 有效组平均年龄(7.3±1.4)岁,无效组平均年龄(7.1±1.9)岁。有效组电刺激电流最大值(19.0+3.2)mA,无效组电刺激电流最大值(17.7+3.8)mA。有效组治疗频率为1～2次/天者135例,0.5～1次/天者135例,<0.5次/天者4例; 无效组治疗频率为1～2次/天者无一例,0.5～1次/天者3例,<0.5次/天者7例。有效组使用药物及伴有尿失禁的患儿分别为115例、51例; 无效组使用药物及伴有尿失禁的患儿分别为1例、2例。单因素分析表明,治疗频率、联合药物奥昔布宁是影响治疗效果的重要因素(P<0.01),而年龄、性别、电刺激电流最大值、合并尿失禁情况比较,差异无统计学意义(P>0.05); 多因素Logistic回归分析表明,治疗频率[比值比Odds Ratio(OR)=0.016,P<0.01]和联合药物奥昔布宁(OR=0.029,P<0.05)是其独立影响因素。结论 治疗频率和联合药物奥昔布宁是影响OAB儿童生物反馈联合电刺激疗效的独立相关因素,通过相对增加治疗频率及联合使用奥昔布宁治疗,可以改善治疗效果。
Objective To explore the influencing factors for biofeedback efficacy in the treatment of children with overactive bladder(OAB). Methods The clinical data were collected for 205 OAB children on biofeedback therapy from January 2016 to June 2017.A retrospective analysis was made for(age±mean)of effective treatment group(n=195)and(age±mean)of ineffective treatment group(n=10).Univariate and multivariate logistic regression analyses were performed for the treatment-related factors,including gender,maximum electrical stimulation current,treatment frequency,concurrent drug(oxybutynin)and urinary incontinence,etc. Results The mean ages of effective and ineffective groups were(7.3±1.4)and(7.1±1.9)years; the maximal stimulating electric currents of effective and ineffective group(19.0±3.2)and(17.7±3.8)mA. Effective group: daily treatment frequency of 1～2 sessions(n=135), 0.5～1(n=135)and <0.5(n=4); ineffective group: daily treatment frequency of 1～2 sessions(n=0), 0.5～1(n=3)and <0.5(n=7). Effective group: use of oxybutynin(n=115)and urinary incontinence(n=51); ineffective group: use of oxybutynin(n=1)and urinary incontinence(n=2). Univariate analysis showed thattreatment frequency and combined use of oxybutynin were important factors affecting the therapeutic effects(P<0.01)while comparisons of age, gender, maximal stimulating electric current and complicating urinary incontinence revealed no differences of statistical significance(P>0.05); multivariate logistic regression analysis showed that frequency of treatment [odds ratio=0.016(P<0. 01)] and combined use of oxybutynin(OR=0.029, P<0.05)were independent influencing factors. Conclusion Treatment frequency and concurrent use of oxybutynin are independent influencing factors for efficacy during biofeedback and electrical stimulation in OAB children.