| 1、 PurposeTo discuss the optimal timing of intervention in postoperative urinary retention by research in the impact on the recovery of bladder function after radical surgery of cervical cancer treated by acupuncture in different time.At the same t ime, the mechanism of the acupuncture in treat ing postoperative urinary retention will be discussed by urodynamic examination. This will be suggestive in guiding clinical treatment opt ions、acupoint select ion and prediction of the therapeutic effect of acupuncture.2、Method60cases of the diagnosed patients with residual urine volume>100ml after seven days of cervical cancer operation will be randomly divided into three groups, the control group、the first treatment group and the second treatment group. The control group will have no acupuncture treatment. The frist treatment group will be treated by acupuncture after the seven days of operation, and the course of the treatment is6days. The second treatment group will be treated by the same way as the frist treatment group after the14th days of operation. All cases will have detection of residual urine volume by B ultrasound and urodynamic examination. And the follow-ups of the frist month and the second month after the operation will be carried out.The acupoints will be BL31-34、BL54、SP9、SP6(both sides), and BL32、BL33will have electrical stimulation and red-ray treatment.3、Result(1)The residual urine volume in control group, the first treatment group and the second treatment group are153.95ml、58.58ml and72.80ml respectively after the frist month of operation, the differences among them are statistically significant(P<0.05), the difference between the control group and the first treatment group is also statistically significant (P<0.0167); The residual urine volume in these three groups are79.74ml,23.16ml,35.00ml respect ively after the second month of operation, the differences among them are statistically significant (P<0.05), the difference between the control group and the first treatment group is statistically significant (P<0.0167);(2) The reduce of the residual urine volume after the treatment are127.68ml、 367.58ml、235.20ml respectively, the differences among them are statistically significant (P<0.05), the difference between the control group and the first treatment group is also statistically significant (P<0.0167);The reduce of the residual urine volume after one month of operation are262.79ml,418.21ml,300.90ml respectively, the differences among them are statistically significant (P<0.05), the difference between the control group and the first treatment group is also statistically significant (P<0.0167); the residual urine volume after two months of operation are337.00ml、453.63ml、338.70ml respectively, the differences among them are not significant(P>0.05).(3) The mean time of retaining catheter among the control group、the frist treatment group and the sencond group are42.11days、23.26days and30.80days respectively, the difference among them are significant (P<0.05) and the differences between the control group and the first treatment group、between the first treatment group and the second treatment group are also significant (P<0.0167)(4) By analysis of urodynamics, the characteristics like that the occurrence of the high tension bladder is more than the lower tension bladder in the patients with postoperative urine retention can be found.Acupuncture can improve urinary flow、enhance the bladder capacity and promote detrusor contractility.4、ConclusionIt has been proved that the efficiecy of electro-acupuncture therapy from the seventh day after operation is better than from the fourteenth day in reducing residual urine volume and shortening the time with catheter.So the intervention in post-operation urinary retention from a earlier time is more benefit for the recovery of bladder function. The mechanism of acupuncture in the recovery of bladder function is to reduce the residual urine volume and promote the repair of the injured sympathetic and parasympathetic. |
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