陈高燕 潘晓迪 胡雅惠 梁雪蕊

【摘要】 目的：探究盆底肌電刺激联合阴道哑铃治疗产后压力性尿失禁（SUI）的临床效果。方法：选择2019年8月-2020年10月阳江市中医医院收治的60例SUI患者为研究对象，采用抽签法将其分为常规组与联合组，每组30例。两组均在康复医师的指导下，根据SUI分度情况选择适宜的盆底肌功能训练，常规组接受盆底肌电刺激治疗，联合组在常规组基础上联合阴道哑铃治疗。比较两组治疗前后SUI分度情况、尿垫试验情况、盆底肌力情况。结果：治疗前，两组SUI分度情况、尿垫试验结果、盆底肌力情况比较，差异均无统计学意义（P>0.05）。治疗后，联合组SUI分度情况、盆底肌力情况均优于常规组，差异均有统计学意义（P<0.05）。治疗后，两组漏尿量均明显少于治疗前，联合组少于常规组，差异均有统计学意义（P<0.05）。结论：盆底肌电刺激联合阴道哑铃治疗产后SUI与仅采用盆底肌电刺激治疗比较，可明显减轻患者SUI临床症状，改善盆底肌力。

【关键词】 盆底肌电刺激 阴道哑铃 产后 压力性尿失禁 尿垫试验 盆底肌力

Evaluation of the Effect of Pelvic Floor Muscle Electrical Stimulation Combined with Vaginal Dumbbell in the Treatment of Postpartum Stress Urinary Incontinence/CHEN Gaoyan， PAN Xiaodi， HU Yahui， LIANG Xuerui. //Medical Innovation of China， 2021， 18（33）： 0-024

[Abstract] Objective： To explore the clinical effect of pelvic floor muscle electrical stimulation combined with vaginal dumbbell in the treatment of postpartum stress urinary incontinence （SUI）. Method： A total of 60 SUI patients admitted to Yangjiang Hospital of Traditional Chinese Medicine from August 2019 to October 2020 were selected as the research subjects， they were divided into conventional group and combined group by lottery， 30 cases in each group. Under the guidance of rehabilitation physicians， appropriate pelvic floor muscle function training was selected for both groups according to the grading of SUI， the conventional group received pelvic floor muscle electrical stimulation treatment， and the combined group received vaginal dumbbell treatment on the basis of the conventional group. The grading of SUI， urine pad test and pelvic floor muscle strength were compared between the two groups before and after treatment. Result： Before treatment， there were no significant differences in SUI grading， urine pad test results and pelvic floor muscle strength between the two groups （P>0.05）. After treatment， SUI grading and pelvic floor muscle strength in the combined group were better than those in the conventional group， the differences were statistically significant （P<0.05）. After treatment， the amount of urine leakage in both groups were significantly less than those before treatment， and the combined group was less than the conventional group， the differences were statistically significant （P<0.05）. Conclusion： Pelvic floor electromyography combined with vaginal dumbbell in the treatment of postpartum SUI can significantly reduce the clinical symptoms of SUI and improve pelvic floor muscle strength compared with the treatment of pelvic floor electromyography alone.

[Key words] Pelvic floor muscle electrical stimulation Vaginal dumbbell Postpartum Stress urinary incontinence Urine pad test Pelvic floor muscle strength

First-author’s address： Yangjiang Hospital of Traditional Chinese Medicine， Yangjiang 529500， China

doi：10.3969/j.issn.1674-4985.2021.33.006

产后尿失禁在临床工作中较为常见，发病机制较为复杂，主要指继发于妊娠与分娩的女性尿失禁，其中最常见的为压力性尿失禁（stress urinary incontinence，SUI）。报道显示，阴道分娩尿失禁发生率可高达38.6%，其中SUI比率高达30.5%[1]。产后SUI的发生可能与盆底组织肌肉、韧带、筋膜在妊娠与分娩过程中受到不同程度损伤，导致盆底结构与功能发生改变相关[2-3]。当前临床普遍将产后作为预防与治疗产后尿失禁的“黄金时机”，干预方法主要为非手术疗法，如生物反馈训练、盆底肌训练、电刺激等[4]。……