摘要
目的探索盆底肌功能锻炼(pelvic floor muscle training,PFMT)与生物电刺激对子宫切除术后尿失禁的治疗效果。方法将2015年6月-2018年6月于榆林市第一医院妇产科行子宫切除术后出现尿失禁的患者作为研究对象,随机分为两组:综合治疗组(n=52),平均年龄(50.9±7.1)岁,采用盆底肌功能锻炼+生物电刺激疗法(神经肌肉刺激治疗仪进行治疗);对照组(n=49),平均年龄(49.8±6.5)岁,只采用盆底肌功能锻炼疗法。观察治疗前后尿失禁主观症状改善情况,1 h尿垫试验和盆底肌力等指标。结果治疗后6个月综合治疗组PFMT频次≥5 d/周者比例(71.2%)高于对照组(49.0%)(P<0.05)。治疗后3个月和6个月:与对照组相比,综合治疗组的ICI-Q-SF评分更低[3个月:4.3±2.2 vs 6.8±3.5,P<0.05;6个月:2.6±1.7 vs 4.2±2.9,P<0.05],尿垫试验漏尿量更少[3个月:(4.3±1.5)g vs(6.6±2.1)g,P<0.05;6个月:(1.4±1.0)g vs(2.3±1.6)g,P<0.05]。综合治疗组Ⅰ类和Ⅱ类肌纤维治疗后3个月和6个月肌力恢复情况均更好(P<0.05)。结论全子宫切除术后尿失禁患者采用PFMT+生物电刺激治疗,盆底肌功能锻炼的依从性和主观症状改善更好,盆底肌力恢复也好于单纯采用盆底肌功能锻炼者。
Objective To explore the therapeutic effect of pelvic floor muscle training(PFMT)and pressure biofeedback in patients with urinary incontinence after hysterectomy.Methods Patients with urinary incontinence after hysterectomy admitted to our hospital from June 2015 to June 2018 were included in our study,and they were randomly divided into the comprehensive treatment group(n=52)with average age of(50.9±7.1)years,and the control group(n=49)with average age of(49.8±6.5)years.Patients in comprehensive treatment group were treated with pelvic floor muscle training plus pressure biofeedback,and patients in control group were treated with pelvic floor muscle training alone.The symptoms of urinary incontinence,1h pad test and pelvic floor muscle strength were observed and compared before and after treatment.Results At 3 and 6 months after treatment,compared with the control group,the amount of urine leakage of pad test in the comprehensive treatment group was less[3 months:(4.3±1.5)g vs(6.6±2.1)g;6 months:(1.4±1.0)g vs(2.3±1.6)g,P<0.05,respectively],the recovery of muscular strength of type I and type II muscle fibers were better(P<0.05),and the ICI-Q-SF score was lower[3 months:(4.3±2.2)vs(6.8±3.5);6 months:(2.6±1.7)vs(4.2±2.9),P<0.05,respectively].At 3 months after treatment,88.5%patients in the comprehensive treatment group and 81.6%patients in the control group performed PFMT more than 5 days per week,showing no significant difference in compliance between the two groups;however,at 6 months after treatment,the percentage of patients performed PFMT>5 days/week in the comprehensive treatment group was higher than that in the control group(71.2%vs 49.0%,P=0.023).Conclusion PFMT plus pressure biofeedback can improve the compliance and subjective symptoms of patients with urinary incontinence after hysterectomy.At the same time,the pelvic floor muscle strength recovery of comprehensive treatment group is better than that of PFMT alone.
作者
许汴菊
张文莉
常蕊
XU Bianju;ZHANG Wenli;CHANG Rui(Department of Obstetrics and Gynecology,the First Hospital of Yulin City,Yulin 719000,Shaanxi Province,China)
出处
《解放军医学院学报》
CAS
2019年第11期1026-1029,共4页
Academic Journal of Chinese PLA Medical School
关键词
盆底肌功能锻炼
生物电刺激
全子宫切除术
尿失禁
pelvic floor muscle training
bioelectrical stimulation
total hysterectomy
urinary incontinence
作者简介
许汴菊,女,硕士,主治医师。研究方向:妇科手术后的盆底康复治疗。Email:18791296264@163.com;通信作者:张文莉,女,在读硕士,主治医师。Email:zhangwenli1985@aliyun.com
