Application of sacral nerve electrical stimulation on the body surface in neurogenic intestinal dysfunction after spinal cord injury
体表骶神经电刺激在脊髓损伤后神经源性肠道功能障碍中的应用研究

摘要

目的 研究体表骶神经电刺激对于脊髓损伤后神经源性肠道功能障碍的治疗效果。方法 选择2019年3月-2023年12月收治的脊髓损伤后神经源性肠道功能障碍患者为研究对象进行分析，随机分为两组，对照组采用常规治疗方法，主要包括药物疗法、饮食调节、腹部按摩、灌肠、栓剂或软化剂，观察组在常规治疗方法基础上增加体表骶神经电刺激疗法，以患者排便次数，每次排便时间以及大便性状评分等作为效果评价标准进行量化评估，并记录排便时有无伴随不适、头痛、大汗。对测得数据采用SPSS 23.0进行统计分析，两样本均数采用配对t检验，以P＜0.05为差异有统计学意义，观察骶神经电刺激疗法对脊髓损伤后肠道功能障碍患者的治疗效果。结果 在大便性状Bristol分级中，对照组为2.13±1.23，实验组为2.52±1.39，两组间差异未达到统计显著性（t=-1.16，p=0.25）。治疗后，对照组的Bristol评分显著低于实验组（2.94±0.93与4.48±1.12，t=-5.92，p=0）。每周排便次数在治疗前对照组为3.19±1.85，实验组为3.55±1.65，差异不显著（t=-0.8，p=0.429），但治疗后实验组（5.29±1.13）明显高于对照组（3.71±1.51，t=-4.67，p=0）。在每次排便时间上，对照组为3.65±1.05，实验组为3.42±1.03，未见显著差异（t=0.856，p=0.395），而治疗后对照组（3.48±0.93）显著高于实验组（2.48±0.72，t=4.735，p=0）。结论 体表骶神经电刺激对脊髓损伤后神经源性肠道功能障碍患者治疗后可改变大便性状分级，缩短排便时间，提高每周排便次数，改善肠道功能障碍。

Abstract

Objective To study the therapeutic effect of sacral nerve electrical stimulation on neurogenic intestinal dysfunction after spinal cord injury.
Methods This study analyzed patients with post-spinal cord injury (SCI) neurogenic bowel dysfunction admitted between March 2019 and December 2023. Participants were randomly divided into two groups: a control group receiving standard treatments (including medication, dietary adjustments, abdominal massage, enemas, suppositories, or stool softeners), and an observation group receiving additional sacral nerve electrical stimulation (SNS) therapy. Treatment efficacy was quantitatively evaluated using bowel movement frequency, duration per defecation, and stool consistency scoring, with documentation of any accompanying symptoms such as discomfort, headache, or excessive sweating. Statistical analysis was performed using SPSS 23.0, with paired t-tests for mean comparisons at the 0.05 significance level. The study aimed to assess the therapeutic effects of SNS therapy on patients with SCI-related bowel dysfunction.
Results In the Bristol stool consistency scoring system, the control group scored 2.13±1.23 while the experimental group scored 2.52±1.39, with no statistically significant difference between groups (t=-1.16, p=0.25). Post-treatment, the control group's Bristol score was significantly lower than the experimental group (2.94±0.93 vs. 4.48±1.12, t=-5.92, p=0). Regarding weekly bowel movement frequency, the control group had 3.19±1.85 before treatment compared to 3.55±1.65 in the experimental group (t=-0.8, p=0.429), showing no significant difference. However, after treatment, the experimental group's frequency (5.29±1.13) was significantly higher than the control group's (3.71±1.51, t=-4.67, p=0). For bowel movement duration, the control group averaged 3.65±1.05 minutes compared to 3.42±1.03 minutes in the experimental group (t=0.856, p=0.395), showing no significant difference. Post-treatment, the control group's duration (3.48±0.93) was significantly longer than the experimental group's (2.48±0.72, t=4.735, p=0).
Conclusion   The treatment of sacral nerve electrical stimulation on the body surface can change the stool grade, shorten the defecation time, increase the frequency of defecation per week, and improve the intestinal dysfunction in patients with neurogenic intestinal dysfunction after spinal cord injury.