Đánh giá hiệu quả điều trị bàng quang tăng hoạt ở người bệnh sau đột quỵ não bằng kích thích thần kinh chày sau tại bệnh viện Bạch Mai=Effectiveness of treatment overactive bladder in post-stroke patients by the posterior tibian nerve stimulation at Bach Mai hospital

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Tác giả: Đào Vũ Đỗ, Thị Linh Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.84-90

Bộ sưu tập: Metadata

ID: 242554

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Đánh giá hiệu quả của phương pháp kích thích thần kinh chày sau (PTNS) trong điều trị bàng quang tăng hoạt (OAB) ở bệnh nhân sau đột quỵ và các yếu tố liên quan. Đối tượng và phương pháp: Nghiên cứu ngẫu nhiên có đối chứng trên 60 bệnh nhân OAB sau đột quỵ tại Trung tâm Phục hồi Chức năng, Bệnh viện Bạch Mai từ tháng 10/2022 đến tháng 6/2023. Bệnh nhân được chia ngẫu nhiên thành hai nhóm: nhóm PTNS và nhóm dùng Solifenacin. Nhóm PTNS điều trị bằng kích thích thần kinh chày sau qua da 3 lần/tuần trong 4 tuần, trong khi nhóm dùng Solifenacin 5mg/ngày. Hiệu quả điều trị được đánh giá qua OABSS, nhật ký đi tiểu, IPS-QoL, và tỷ lệ tác dụng phụ. Kết quả: Sau 4 tuần, nhóm PTNS giảm điểm OABSS trung bình 1,85 ± 0,895 (p<
0,05), thấp hơn so với nhóm Solifenacin (2,87 ± 1,28, p<
0.05). Cả nhóm PTNS và nhóm Solifenacin đều cải thiện triệu chứng tiết niệu (p<
0.05). Điểm IPS-QoL của nhóm PTNS cải thiện từ 4,46 ± 0,86 xuống 3,77 ± 1,07. Nhóm PTNS có tỷ lệ tác dụng phụ thấp hơn đáng kể (3,85% so với 26,67%, p<
0,05). Tuổi cao (>
70) và thời gian mắc bệnh >
3 tháng ảnh hưởng tiêu cực đến kết quả điều trị. Kết luận: PTNS là phương pháp điều trị hiệu quả và an toàn cho OAB sau đột quỵ, giảm triệu chứng và cải thiện chất lượng cuộc sống. Mặc dù hiệu quả điều trị kém hơn Solifenacin, PTNS có ít tác dụng phụ hơn, làm cho nó trở thành lựa chọn tiềm năng cho điều trị OAB với các yếu tố như tuổi cao và thời gian mắc bệnh cần lưu ý.To evaluate the effectiveness of posterior tibial nerve stimulation (PTNS) in the treatment of overactive bladder (OAB) in poststroke patients and related factors. Subjects and methods: A randomized controlled study on 60 post-stroke OAB patients at the Rehabilitation Center, Bach Mai Hospital from October 2022 to June 2023. Patients were randomly divided into two groups: the PTNS group and the Solifenacin group. The PTNS group was treated with percutaneous posterior tibial nerve stimulation 3 times/week for 4 weeks, while the Solifenacin group was treated with 5 mg/day of Solifenacin. Treatment efficacy was assessed by OABSS, voiding diary, IPSSQoL, and side effect rate. Results: After 4 weeks, the PTNS group had a mean OABSS score reduction of 1.85±0.895 (p<
0.05), lower than the Solifenacin group (2.87±1.28, p<
0.05). Both the PTNS and Solifenacin groups improved urinary symptoms (p<
0.05). The IPS-QoL score of the PTNS group improved from 4.46±0.86 to 3.77±1.07. The PTNS group had a significantly lower rate of side effects (3.85% vs. 26.67%, p<
0.05). Older age (>
70) and disease duration >
3 months negatively affected treatment outcomes. Conclusion: PTNS is an effective and safe treatment for post-stroke OAB, reducing symptoms and improving quality of life. Although less effective than Solifenacin, PTNS has fewer side effects, making it a potential option for OAB treatment with factors such as advanced age and disease duration being taken into account.

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