Randomized prospective crossover study of interstim lead wire placement with curved versus straight stylet
Randomized prospective crossover study of interstim lead wire placement with curved versus straight stylet
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DOI：
10.1002/nau.22437
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发表时间：
2014-06-01
影响因子：
2
通讯作者：
Noblett, Karen L.
中科院分区：
文献类型：
--
作者：
Jacobs, Stephanie A.;Lane, Felicia L.;Noblett, Karen L.
目的 评估与使用直管心针相比，使用弯曲管心针放置 InterStim 导联线是否能以较低幅度实现运动响应。方法 这是一项针对计划接受 InterStim 导联线置入的患者的前瞻性、随机、交叉研究。所有患者均使用弯曲和直管心针进行导联测试。患者被随机确定管心针顺序，然后交叉到备用。术中，记录每个电极处实现运动反应的幅度。具有最低总振幅的管心针用于最终放置。主要结果测量是两个最深（0 和 1）电极的振幅要求。次要结果包括 2 号和 3 号电极的振幅、组合振幅、探针顺序和不良结果。结果共纳入42例患者，其中40例进入最终分析。平均年龄为 69 岁 (SD=12.8)，平均 BMI 为 27 (SD=5.6)。放置适应症包括：急迫性尿失禁（N=26）、急迫性尿失禁（N=25）、非梗阻性尿潴留（N=5）和大便失禁（N=10）。随机组之间没有显着差异。无论顺序如何，弯曲探针在最深电极中以较低幅度实现了运动响应（P
Aims To assess whether InterStim lead wire placement with the curved stylet achieves motor response at lower amplitudes compared to straight stylet use. Methods This was a prospective, randomized, crossover study of patients scheduled for InterStim lead wire placement. All patients underwent lead wire testing with both the curved and straight stylets. Patients were randomized to determine stylet order, and then crossed-over to the alternate. Intra-operatively, the amplitude achieving motor response at each electrode was recorded. The stylet with lowest overall amplitudes was used for final placement. Primary outcome measure was amplitude requirement in the two deepest (0 and 1) electrodes. Secondary outcomes included amplitudes at the number 2 and 3 electrodes, combined amplitudes, stylet order, and adverse outcomes. Results Forty-two patients were enrolled, 40 of whom were included in the final analysis. Mean age was 69 years (SD=12.8) and mean BMI 27 (SD=5.6). Indications for placement included: urge urinary incontinence (N=26), urge/frequency (N=25), non-obstructive urinary retention (N=5), and fecal incontinence (N=10). There were no significant differences between randomized groups. Regardless of order, the curved stylet achieved a motor response at lower amplitudes in the deepest electrodes (P