盆底肌电刺激治疗女性真性压力性尿失禁的近期疗效  

Short-term effects of pelvic floor electrical stimulation on genuine stress urinary incontinence in women

作　　者：苏静[1] 文建国[1] 王庆伟[1] 张鹏[1] 刘奎[1] 张瑞利[1] 

机构地区：[1]郑州大学第一附属医院尿动力学中心

出　　处：《中国临床康复》2006年第13期131-133,共3页Chinese Journal of Clinical Rehabilitation

基　　金：国家自然科学基金(30571931);河南省杰出青年科学基金(02120001100);河南省高校杰出科研人才创新工程项目(2001KYCX004);河南省高等学校创新人才培养工程资助项目(2002-2007)~~

摘　　要：目的:观察应用神经肌肉电刺激治疗仪治疗女性真性压力性尿失禁的近期疗效。方法:选择2004-08/2005-06在郑州大学第一附属医院尿动力学中心就诊的真性压力性尿失禁女性患者50例,均自愿参加观察。患者治疗前记录3d排尿日记,填写国际尿失禁咨询委员会尿失禁问卷简表,并按照世界尿控协会推荐的标准进行尿动力学测定。使用神经肌肉电刺激治疗仪进行盆底肌电刺激治疗,采用表面电极,置于会阴部尿道括约肌处。电刺激模式为专为盆底肌锻炼设计的一组程序化刺激。3次/周,每次60min/次,共治疗12周。治疗结束前3d开始记录排尿日记,刺激结束后复查尿动力学和填写国际尿失禁咨询委员会尿失禁问卷简表(主要反应尿失禁的发生率和尿失禁对患者生活的影响程度,共21分,分值越高尿失禁越严重)评估治疗效果。结果:50例患者全部进入结果分析,无脱落。①盆底肌电刺激治疗对患者的干预效果:经过12周治疗后,24例患者(48%)尿失禁症状消失,21例患者(42%)尿失禁症状改善,5例患者(10%)尿失禁症状无改善。②患者治疗前及治疗12周后的尿动力学主观、客观指标比较:患者治疗12周后功能性膀胱容量、valsalva漏尿点压、最大尿道压和最大尿道闭合压显著高于治疗前(t=2.309～2.840,P<0.05),总排尿次数、总漏尿事件次数和尿失禁评分显著低于治疗前(t=3.389～3.415,P<0.05)。结论:应用神经肌肉电刺激治疗仪治疗女性真性压力性尿失禁近期疗效显著,可以明显改善患者的尿失禁症状,具有无创伤和经济方便的优点,患者依从性较好。AIM： To observe the short-term effect of pelvic floor electrical stimulation on genuine stress urinary incontinence （GSUI） in women by using the NeuroTrac^TM. METHODS： We chose 50 female patients with GSUI who received the treatment of Urodynamic Center, First Hospital Affiliated to Zhengzhou University from August 2004 to June 2005. They participated in the experiment voluntarily. Urinary diary of the patients was recorded for 3 days before treatment. International urinary continence inquiring committee＇s questionnaire （ICI-Q-SF） was filled in and urodynamics evaluation was performed according to the criteria recommended by international continence society （ICS）. NeuroTracTM was used to conduct pelvic floor electrical stimulation and the skin surface electrode was put at the urethral sphincter of perineal region. Electrical stimulation mode was sequencing stimulation which designed specially for pelvic muscle exercise. The patients were treated 3 times a week, 60 minutes once, 12 weeks in total. Urinary diary was recorded at the last 3 days of the treatment. Urodynamics evaluation and ICI-Q-SF were re-examined to evaluate curative effect after stimulation （frequency of incontinence and the effect of incontinence on the life of patients were scored, totally 21 scores, the more scores the severer urinary incontinence）. RESULTS： Totally 50 patients entered the stage of result analysis, with no one lost. Effect of pelvic floor electrical stimulation： After 12-week treatment, the symptom of incontinence disappeared in 24 patients （48%）, improved in 21 patients （42%）, did not improve in 5 patients （10%）.Comparison of subjective and objective index of urodynamics before and 12 weeks after treatment： After 12-week treatment, the functional cystic capacity, Valsalva leak point pressure, maximal urethral pressure and maximal urethral closure pressure were significantly larger and higher as compared with before treatment （t=2.309-2.840, P 〈 0.05）. The total frequency of ure

关 键 词：尿失禁 压力性 电刺激 尿动力学 

分 类 号：R454.15[医药卫生—治疗学]