盆底肌锻炼配合电刺激治疗SUI的可行性分析
2017-06-08黎佩莹谢谨何洁芳黄巧如谢德文
黎佩莹 谢谨 何洁芳 黄巧如 谢德文


【摘要】 目的:研究分析盆底肌锻炼配合电刺激治疗压力性尿失禁(stress urinary incontinence,SUI)的可行性。方法:选取2015年10月-2016年月2月产后SUI患者98例,按照就診ID号奇、偶数分为观察组和对照组,各49例,对照组在基本治疗基础上实行盆底肌锻炼,观察组在对照组基础上联合电刺激治疗,比较两组治疗后临床治疗效果、生活质量评分(I-QOL量表)、肌纤维肌力以及尿动力学指标等情况。结果:所有患者均顺利完成治疗,观察组治疗总有效率(93.9%)显著优于对照组(79.6%),差异有统计学意义(P<0.05);观察组生活质量总评分以及各项评分均优于对照组,差异均有统计学意义(P<0.05);治疗后,两组Ⅰ、Ⅱ类肌纤维肌力较治疗前均明显改善(P<0.05),观察组治疗后Ⅰ、Ⅱ类肌纤维肌力均优于对照组,差异均有统计学意义(P<0.05);尿动力学指标比较,观察组功能尿道长度(PVLP)、膀胱最大容量(MUCP)、尿道最大测量压(PMU)、膀胱顺应性(BC)、最大尿流率时逼尿肌压力(LSF)、Valsalva漏尿点压(VMCC)、最大尿流率(PQmax)均优于对照组,差异均有统计学意义(P<0.05)。结论:采用盆底肌锻炼配合电刺激治疗SUI有效可行,可显著改善患者生活质量,提高患者盆底肌收缩功能以及机体排尿功能。
【关键词】 盆底肌锻炼; 电刺激; 压力性尿失禁; 尿动力学
Feasibility Analysis of SUI Patients Treated with Pelvic Floor Muscle Exercises Combined with Electrical Stimulation/LI Pei-ying,XIE Jin,HE Jie-fang,et al.//Medical Innovation of China,2017,14(14):104-107
【Abstract】 Objective:To analyze the feasibility of stress urinary incontinence(SUI) patients treated with pelvic floor muscle exercises combined with electrical stimulation.Method:A total of 98 SUI patients from October 2015 to February 2016 treated in our hospital were chosed and divided into the control group and the observation group according to the parity of ID number.The control group was treated with pelvic floor muscle exercises,the observation group was treated with electrical stimulation on the basic of control group.The therapeutic effect,quality of life(I-QOL scale),changes of muscle fiber strength and urodynamic index of two grouops were compared.Result:The total therapeutic efficiency of the observation group was 93.9%,was significantly better than 79.6% of the control group(P<0.05).The each section score and total score of the observation group were significantly better than those of the control group(P<0.05).Ⅰ,Ⅱ muscle fiber strength of two group after treatments were significantly better than the strength before treatments(P<0.05).Ⅰ,Ⅱ muscle fiber strength of the observation group were significantly better than those of the control group(P<0.05).PVLP,PMUC,PMU,BC,LSF,VMCC,PQmax of the observation group were significantly better than those of the control group(P<0.05).Conclusion:The pelvic floor muscle exercises combined with electrical stimulation is an effective treatment for SUI patients,which can improve the quality of life of patients,enhance pelvic floor muscle contractile function and urination function of organism.It deserves a further application in clinical treatment.
【Key words】 Pelvic floor muscle exercises; Electrical stimulation; Stress urinary incontinence; Urodynamics
First-authors address:The Peoples Hospital of Dongguan,Dongguan 523059,China
doi:10.3969/j.issn.1674-4985.2017.14.028
压力性尿失禁(SUI)为产后常见并发疾病之一,以腹压增高时伴有不自主尿液漏出为主要表现,尽管患者无生命危害,但对患者社交活动以及生活质量造成严重困扰[1]。针对于轻、中度患者,临床以盆底肌锻炼为主要的保守治疗方案,但随着治疗周期延长,患者依从性下降,其治疗效果难以得到有效保证[2]。近来文献报道指出,生物反馈电刺激在盆底功能障碍性疾病中疗效显著,可有效改善盆底功能障碍状况,应用便捷、不良反应少[3-4]。为进一步提高临床治疗效果,本组研究选取2015年10月-2016年月2月产后SUI患者98例,以盆底肌锻炼为对照,研究分析盆底肌锻炼配合电刺激治疗SUI可行性,现报道如下。
1 资料与方法
1.1 一般资料 选取2015年10月-2016年月2月产后SUI患者98例,按照就诊ID号奇、偶数分为观察组与对照组,各49例。对照组平均年龄(34.3±5.6)岁,体重指数(25.6±2.2)kg/m2,分娩平均次数(1.6±1.1)次。……
