实用老年医学

实用老年医学 ›› 2026, Vol. 40 ›› Issue (4): 340-343.doi: 10.3969/j.issn.1003-9198.2026.04.003

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老年神经源性下尿路功能障碍患者骶神经调控疗效的影响因素分析

莫斯斯, 余燕岚   

  1. 310016 浙江省杭州市,浙江大学医学院附属邵逸夫医院泌尿外科
  • 收稿日期:2026-01-20 出版日期:2026-04-23 发布日期:2026-04-23
  • 通讯作者: 余燕岚,Email:yanlanyu@zju.edu.cn

Analysis of factors related to therapeutic efficacy of sacral nerve modulation in elderly patients with neurogenic lower urinary tract dysfunction

MO Sisi, YU Yanlan   

  1. Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
  • Received:2026-01-20 Online:2026-04-23 Published:2026-04-23
  • Contact: YU Yanlan, Email:yanlanyu@zju.edu.cn

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摘要： 目的 探讨老年神经源性下尿路功能障碍(neurogenic lower urinary tract dysfunction,NLUTD)患者骶神经调控(sacral nerve modulation,SNM)二期转化率的影响因素。 方法 回顾性分析2017—2025年于浙江大学医学院附属邵逸夫医院接受SNM一期测试的123例60岁以上老年NLUTD患者的临床资料。根据疗效以及是否接受二期永久植入,分为转化成功组(n=85)与转化失败组(n=38)。收集年龄、性别、病程、BMI、症状分型以及残余尿量等资料,采用单因素及多因素logistic回归分析探讨二期转化成功率的影响因素。 结果 单因素分析显示,2组间年龄、性别及BMI差异均无统计学意义(P>0.05),病程、残余尿量及症状分型(储尿期/排尿期症状)差异有统计学意义(P＜0.05)。进一步多因素logistic回归分析显示,在校正年龄、性别及BMI后,较长病程(OR=0.785, 95%CI: 0.650~0.947, P=0.012)和排尿期功能障碍(以储尿期功能障碍为参照,OR=0.243, 95%CI: 0.086~0.691, P=0.008)是二期转化成功率的独立影响因素。 结论 病程较长以及排尿期功能障碍(如排尿困难、尿潴留)是老年NLUTD患者SNM二期转化成功率降低的独立危险因素,建议在临床决策中更早评估并筛选潜在获益患者。   

关键词: 神经源性下尿路功能障碍, 骶神经调节, 二期转化, 危险因素, 老年人

Abstract: Objective To investigate the influencing factors of the stage Ⅱ conversion rate of sacral nerve modulation (SNM) in the elderly patients with neurogenic lower urinary tract dysfunction(NLUTD). Methods A retrospective analysis was performed on the clinical data of 123 elderly NLUTD patients aged over 60 years who underwent stage Ⅰ SNM testing in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from January 2017 to December 2025. According to the efficiency and whether they received stage Ⅱ permanent implantation, the patients were divided into the successful conversion group (n=85) and the failed conversion group (n=38). Potential influencing factors were collected, including age, gender, disease course, body mass index (BMI), symptom classification and post-void residual urine. Univariate analysis and multivariable logistic regression analysis were conducted to investigate the influening factors. Results Univariate analysis showed no statistically significant differences in age, gender, and BMI (all P>0.05), while significant differences were observed in disease duration, post-void residual urine, and symptom type between the two groups (all P<0.05). Further multivariable logistic regression analysis revealed that, after adjusting for age, gender, and BMI, longer disease duration (OR=0.785, 95%CI: 0.650-0.947, P=0.012) and voiding-phase dysfunction (with storage-phase dysfunction as reference, OR=0.243, 95%CI: 0.086-0.691, P=0.008) were independent risk factors of successful stage Ⅱ conversion. Conclusions Longer disease course and predominant clinical manifestations of voiding-phase dysfunction (such as dysuria and urinary retention) are independent risk factors for decreased stage Ⅱ conversion rate of SNM in elderly NLUTD patients. It is recommended that potential beneficial patients be evaluated and screened earlier in clinical decision-making.

Key words: neurogenic lower urinary tract dysfunction, sacral nerve modulation, stage Ⅱ conversion, risk factors, aged

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