中华保健医学杂志

目的 研究双氯芬酸钠联合生物反馈电刺激治疗前列腺增生术后膀胱痉挛(BS)疗效及对患者生活质量影响。方法 回顾性选取上海交通大学医学院附属新华医院2022年1月～2024年12月收治的前列腺增生术后膀胱痉挛患者116例，根据治疗方案不同分为两组，其中接受常规治疗的患者58例作为对照组，在常规治疗的基础上采用双氯芬酸钠联合生物反馈电刺激治疗的58例患者作为观察组。比较两组患者治疗后平均排尿量、尿失禁次数、拔管时间、拔管后尿潴留发生率和术后BS的发生次数及持续时间，并以视觉模拟评分法(VAS)评估术后BS疼痛程度；回顾性提取并统计两组患者前列腺增生术后不良反应发生情况，采用膀胱状况感知量表(PPBC)和膀胱过度活动症评分(OABSS)评估膀胱状况；采用汉密尔顿焦虑量表(HAMA)评价患者焦虑情绪；采用自制量表评估患者生活质量恢复情况满意度。结果 术后观察组拔管时间(3.75±0.53)d、尿失禁次数(0.39±0.07)次，显著低于对照组的(7.12±0.69)d、(1.54±0.71)次，平均排尿量(177.13±28.22)mL显著高于对照组的(123.55±27.89)mL,差异有统计学意义(t=29.498、12.276、10.285,P<0.05);拔管后尿潴留发生率(5.17%)显著低于对照组(17.24%),差异有统计学意义(χ²=4.245,P<0.05)。术后3 d,观察组BS发生频率、BS持续时间、VAS评分均显著低于对照组，差异有统计学意义(P<0.05)。治疗后，两组患者PPBC、OABSS、HAMA评分均显著降低，且观察组低于对照组，差异有统计学意义(t=72.806、26.770、8.789,P<0.05)。治疗后，观察组患者生活质量恢复总满意度为91.38%,显著高于对照组74.14%,差异有统计学意义(P<0.05)。治疗后，观察组不良反应发生率(8.62%)与对照组(15.52%)比较，差异无统计学意义(χ²=1.300,P> 0.05)。结论 对前列腺增生术后膀胱痉挛患者采用双氯芬酸钠联合生物反馈电刺激治疗效果较好，可有效降低BS发生频率并缩短其发作持续时间，缓解疼痛程度，改善临床症状，显著提高患者的生活质量，且未见不良反应增加，具有较高的安全性。

Objective To study the efficacy of diclofenac sodium combined with biofeedback electrical stimulation in the treatment of bladder spasm(BS)after prostatic hyperplasia and its influence on patients' quality of life. Methods A retrospective selection of 116 patients with postoperative bladder spasm after benign prostatic hyperplasia(BPH)treated at our hospital from January 2022 to December 2024. Divided into two groups according to different treatment plans. Among them, 58 patients receiving conventional treatment were used as the control group, and 58 patients receiving conventional treatment combined with diclofenac sodium and biofeedback electrical stimulation were used as the study group. The average urinary volume, frequency of urinary incontinence, extubation time, incidence of urinary retention after extubation, frequency, and duration of postoperative BS were compared between the two groups, and the degree of postoperative BS pain was assessed by visual analogue scale(VAS). Adverse reactions were retrospectively extracted and statistically compared between the two groups. The bladder condition perception Scale(PPBC)and overactive bladder score(OABSS)were used to evaluate the bladder status. Hamilton Anxiety Scale(HAMA)was used to evaluate patients' anxiety. The patients' satisfaction with quality of life recovery was assessed by self-made scale. Results After treatment, the average urine output of the study group(177.13 ± 28.22)mL and the total satisfaction with the recovery of patients' quality of life(91.38%)were significantly higher than those of the control group[(123.55 ± 27.89)mL and(74.14%)],and the difference was statistically significant(t value=10.285,P < 0.05). Extubation time(3.75 ± 0.53)days, incidence of urinary retention after extubation(5.17%),frequency of urinary incontinence(0.39 ± 0.07)times, OABSS(1.42 ± 0.33)points, HAMA(9.69 ± 1.42)points and PPBC(2.36 ± 0.14)points Significantly lower than those of the control group [(7.12 ± 0.69)days,(17.24%)times,(1.54 ± 0.71)times,(3.27 ± 0.41)points,(12.53 ± 2.01)points,(4.54 ± 0.18)points]The differences were statistically significant(t/χ²=29.498,4.245,12.276,26.770,8.789,72.806 respectively, P < 0.05). At different postoperative time periods, the occurrence frequencies of BS,BS duration and VAS score in the study group were significantly lower than that of the control group, and the difference was statistically significant(P < 0.05). The incidence of adverse reactions after treatment in the study group(8.62%)was not significantly different from that in the control group(15.52%)(χ²=1.300,P > 0.05). Conclusion Diclofenac sodium combined with biofeedback electrical stimulation can effectively reduce the frequency of BS and shorten the duration of its attack, relieve pain, improve clinical symptoms, and significantly improve the quality of life of patients with bladder spasm after surgery for prostatic hyperplasia, with high safety.