Bulletin of Rehabilitation Medicine Bulletin of Rehabilitation Medicine Вестник восстановительной медицины 2078-1962 2713-2625 68973 10.38025/2078-1962-2022-21-5-68-77 Технологии восстановительной медицины и медицинской реабилитации Rehabilitation Medicine and Medical Rehabilitation Technologies Технологии восстановительной медицины и медицинской реабилитации Safety and Effectiveness of Magnetic Stimulation in the Rehabilitation of Children with Neurogenic Urinary Incontinence: a Prospective Open Randomized Controlled Clinical Study Безопасность и эффективность магнитной стимуляции в реабилитации детей с нейрогенным недержанием мочи: проспективное открытое рандомизированное контролируемое клиническое исследование https://orcid.org/0000-0001-5560-6235 Воловец С. А. Volovets. Svetlana A. https://orcid.org/0000-0002-1407-3038 Бадалов Н. Г. Badalov. Nazim G. https://orcid.org/0000-0001-7526-1553 Бородулина И. В. Borodulina. Irina V. https://orcid.org/0000-0003-1666-8147 Ефимова В. И. Efimova. Vera I. https://orcid.org/0000-0002-5260-8304 Яковлев М. Ю. Yakovlev. Maxim Y. Научно-практический центр медико-социальной реабилитации им. Л.И. Швецовой, Москва, Россия ru Научно-практический центр медико-социальной реабилитации им. Л.И. Швецовой, Москва, Россия ru Первый Московский государственный медицинский университет им. И.М. Сеченова, Москва, Россия ru Первый Московский государственный медицинский университет им. И.М. Сеченова, Москва, Россия ru Российская медицинская академия непрерывного профессионального образования, Москва, Россия ru Российская медицинская академия непрерывного профессионального образования, Москва, Россия ru Национальный медицинский исследовательский центр реабилитации и курортологии, Москва, Россия ru Национальный медицинский исследовательский центр реабилитации и курортологии, Москва, Россия ru 25 10 2022 25 10 2022 21 5 68 77 12 10 2022 20 10 2022 https://nmicrk.editorum.ru/en/nauka/article/68973/view

ВВЕДЕНИЕ. Недержание мочи у детей является междисциплинарной проблемой. Распространённость недержания мочи колеблется от 3,1% до 8,6% и уменьшается с возрастом. Недержание мочи может быть вызвано как органическими (заболевания мочеполовой системы, неврологическая патология), так и функциональными причинами. Одним из методов немедикаментозной коррекции недержания мочи является экстракорпоральная магнитная стимуляция, применяемая у взрослых пациентов. В то же время эффективность метода среди педиатрической популяции изучена недостаточно. ЦЕЛЬ. Изучить эффективность и безопасность ЭМС в комплексной реабилитации детей с нейрогенным недержанием мочи. МАТЕРИАЛ И МЕТОДЫ. Мы включили в проспективное открытое рандомизированное контролируемое клиническое исследование 75 пациентов педиатрического профиля (от 5 лет до 16 лет и 6 месяцев) с клинической формой дневного и ночного недержания мочи, которые были разделены методом простой рандомизации на основную группу (n=39), получавшую стандартную программу реабилитации и экстракорпоральную магнитную стимуляцию в течение 21 дня, и группу сравнения (n=36), в которой стандартная программа реабилитации не включала использование ЭМС. РЕЗУЛЬТАТЫ И ОБСУЖДЕНИЕ. Проспективное открытое рандомизированное сравнительное исследование показало, что клиническая эффективность метода экстракорпоральной магнитной стимуляции в комплексной реабилитации детей с нейрогенным недержанием мочи составляет 94,8%, что на 25,4% выше, чем в группе сравнения. После лечения у пациентов основной группы заметно уменьшилось количество эпизодов недержания мочи, увеличился объем мочеиспускания, улучшилось качество жизни. На лечение показало эффективность в случае с пациентами с различной фоновой неврологической патологией, что свидетельствует об общих патогенетических механизмах развития симптомов нижних мочевыводящих путей при этих состояниях и независимости конечного эффекта от основного диагноза. ЗАКЛЮЧЕНИЕ. Применение метода экстракорпоральной магнитной стимуляции промежности у детей с нейрогенным недержанием мочи повышает эффективность реабилитации и является перспективным и безопасным направлением восстановительного лечения.

INTRODUCTION. Urinary incontinence in children is an interdisciplinary problem. The prevalence of urinary incontinence ranges from 3.1% to 8.6% and decreases with age. Urinary incontinence can be caused by both organic (diseases of the genitourinary system, neurological pathology) and functional causes. One of the methods of non-drug correction of urinary incontinence is extracorporeal magnetic stimulation, used in adult patients. At the same time, the effectiveness of the method among the pediatric population has not been sufficiently studied. AIM. To study the effectiveness and safety of extracorporeal magnetic stimulation in the comprehensive rehabilitation of children with neurogenic urinary incontinence. MATERIAL AND METHODS. A prospective open randomized controlled clinical study included 75 pediatric patients (from 5 years to 16 years and 6 months) with a clinical form of day and night urinary incontinence, who were divided by simple randomization into a main group (n=39), who received a standard rehabilitation and extracorporeal magnetic stimulation program for 21 days, and a comparison group (n=36), in which the standard rehabilitation program did not include the use of extracorporeal magnetic stimulation. RESULTS AND DISCUSSION. A prospective open randomized comparative study revealed that the clinical effectiveness of the extracorporeal magnetic stimulation method in the comprehensive rehabilitation of children with neurogenic urinary incontinence is 94.8%, which is 25.4% higher than in the comparison group. After treatment, patients in the main group had a noticeable decrease in urinary incontinence episodes, an increase in the micturition volume, and an improvement in the quality of life. Patients with various background neurological pathology responded to treatment, which indicates the common pathogenetic mechanisms of the development of lower urinary tract symptoms in these conditions and the independence of the final effect from the basic diagnosis. CONCLUSION. The use of the perineal extracorporeal magnetic stimulation method in children with neurogenic urinary incontinence increases the effectiveness of rehabilitation and is a promising and safe direction of rehabilitation treatment.

 магнитная стимуляция недержание мочи дети magnetic stimulation urinary incontinence children

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