体表电刺激对脑卒中后排尿障碍临床疗效的Meta分析
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摘要
目的通过Meta分析系统评价体表电刺激对脑卒中后排尿障碍的影响。方法计算机检索中国知网、维普资源系统、万方、PubMed数据库中关于体表电刺激对脑卒中后患者排尿障碍影响的随机对照试验,时间自建刊(库)开始到2018年9月。收集干预措施为体表电刺激、研究对象为脑卒中后排尿障碍的随机对照试验(RCT),使用Stata12.0软件进行Meta分析。结果最后纳入的17篇文献中评价方法以临床疗效最多,故以11篇文献中临床疗效作为效应量进行分析。疗效森林图显示,10篇研究的同质性较好,RR=1.332,95%CI [1.245,1.425],P <0.001差异有显著统计学意义,可认为体表电刺激治疗脑卒中后排尿障碍有效。Begg图及Egger图显示研究对象分布不对称,提示可能存在一定的发表偏倚。结论体表电刺激可改善脑卒中后排尿功能,但尚需更多高质量临床研究以增加证据的强度。
Objective to evaluate effect of body surface electrical stimulation on urinary dysfunction after stroke by Meta-analysis system. Methods carry on computer retrieval of randomized controlled trials of surface electrical stimulation effect on urinary dysfunction of stroke patients in databases of China HowNet, Wipe Resources System,Wanfang and PubMed, with time from journal establishment to September 2018. Collect randomized controlled trials(RCTs) with body surface electrical stimulation and study objects of urinary dysfunction after stroke. Carry on Metaanalysis with Stata 12.0 software. Results among 17 literatures included finally, clinical effect was the most evaluation methods, so 11 literatures were analyzed with effect quantity of clinical effect. Curative forest map showed homogeneity of 10 studies was good, RR = 1.332, 95% CI [1.245, 1.425], P< 0.001, difference showed statistical significance, which can be concluded that surface electrical stimulation was effective in treatment of post-stroke urinary dysfunction. Begg and Egger diagrams showed asymmetric distribution of subjects, suggesting that there may be publication bias. Conclusion surface electrical stimulation can improve urinary function after stroke, but more high-quality clinical studies are needed to increase intensity of evidence.
Objective to evaluate effect of body surface electrical stimulation on urinary dysfunction after stroke by Meta-analysis system. Methods carry on computer retrieval of randomized controlled trials of surface electrical stimulation effect on urinary dysfunction of stroke patients in databases of China HowNet, Wipe Resources System,Wanfang and PubMed, with time from journal establishment to September 2018. Collect randomized controlled trials(RCTs) with body surface electrical stimulation and study objects of urinary dysfunction after stroke. Carry on Metaanalysis with Stata 12.0 software. Results among 17 literatures included finally, clinical effect was the most evaluation methods, so 11 literatures were analyzed with effect quantity of clinical effect. Curative forest map showed homogeneity of 10 studies was good, RR = 1.332, 95% CI [1.245, 1.425], P< 0.001, difference showed statistical significance, which can be concluded that surface electrical stimulation was effective in treatment of post-stroke urinary dysfunction. Begg and Egger diagrams showed asymmetric distribution of subjects, suggesting that there may be publication bias. Conclusion surface electrical stimulation can improve urinary function after stroke, but more high-quality clinical studies are needed to increase intensity of evidence.
引文
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[16]杨晓慧,张淑丽,罗红梅.低频脉冲电治疗对脑卒中后尿潴留的临床观察[J].中国老年学杂志,2008(22):2263-2264.
[17]曹克勇,雷海瑛.低频电刺激治疗脑卒中后尿潴留的疗效观察[J].中国康复,2014,29(01):52-54.
[18]刘艺,许纲,黄敬.不同频率经皮神经电刺激改善脑卒中后尿失禁的比较[J].中国康复理论与实践,2015,21(05):562-566.
[19]苏雅茹.尿失禁与脑血管意外[J].中国临床神经科学,2003(01):92-94.
[2]文怡川,李娜,袁道玉,等.针刺配合体表电刺激治疗急性脑卒中后尿潴留的临床观察[J].针灸临床杂志,2018,34(07):32-35.
[3]刘红,赖米娜.针刺结合中频脉冲电治疗中风后尿潴留疗效观察[J].实用中医药杂志,2018,34(07):837-838.
[4]李园,王柔昉,张惠虹.针刺结合中频脉冲电治疗脑卒中后尿潴留30例疗效观察[J].内蒙古中医药,2013,32(24):68-69.
[5]高珠英,陈雪琼.突发电刺激结合间歇性导尿治疗脑卒中后尿潴留30例的疗效观察[J].广东医学院学报,2013,31(04):454-455.
[6]魏清川,奚颖,马惠,等.体表电刺激治疗急性脑卒中后排尿障碍的临床观察[J].中国康复医学杂志,2012,27(03):235-239.
[7]王东生.生物电反馈加超声波治疗脑卒中后急迫性尿失禁93例[J].中国临床康复,2003,7(25):3514-3514.
[8]安晓蕾,王淑秀.膀胱神经肌肉电刺激治疗急性脑卒中后排尿障碍的临床观察[J].现代医学,2014,42(09):1047-1050.
[9]黄爱华,任平,车加丽,等.膀胱电刺激治疗脑卒中尿失禁的方法与效果[J].护理管理杂志,2012,12(07):517-518.
[10]窦丽辉,王金果.脑卒中后尿失禁应用穴位中频电刺激与Kegel运动治疗的效果分析[J].世界最新医学信息文摘,2015,15(53):33.
[11]王存志,任书文,闫一团.经皮穴位电刺激治疗脑卒中后急迫性尿失禁观察[J].中西医结合心脑血管病杂志,2017,15(03):376-379.
[12]刘艺,赵延欣,许云飞,等.经皮神经电刺激治疗脑卒中后尿失禁[J].同济大学学报(医学版),2012,33(03):105-108.
[13]袁元宵.经皮电刺激法对脑卒中后尿失禁患者生活质量的影响[J].临床护理杂志,2013,12(05):48-49.
[14]伍丹,许燕玲,蒋伶俐,等.干扰电疗法治疗脑卒中尿失禁的临床疗效观察[J].临床医学工程,2008(10):15-16.
[15]杨志华,万文辉,陈晓莲.电脑中频联合针刺治疗脑中风后尿潴留的疗效观察[J].中国城乡企业卫生,2017,32(09):109-110.
[16]杨晓慧,张淑丽,罗红梅.低频脉冲电治疗对脑卒中后尿潴留的临床观察[J].中国老年学杂志,2008(22):2263-2264.
[17]曹克勇,雷海瑛.低频电刺激治疗脑卒中后尿潴留的疗效观察[J].中国康复,2014,29(01):52-54.
[18]刘艺,许纲,黄敬.不同频率经皮神经电刺激改善脑卒中后尿失禁的比较[J].中国康复理论与实践,2015,21(05):562-566.
[19]苏雅茹.尿失禁与脑血管意外[J].中国临床神经科学,2003(01):92-94.