生物反馈电刺激联合盆底肌训练治疗全子宫切除术后压力性尿失禁患者的临床研究  

The clinical research of biofeedback electrical stimulation plus PFMT in the treatment of stress urinary incontinence after total hysterectomy

作　　者：刘玉嵚 李永川[1] 艾小庆 邢玥[1] 马婷 沈莉平[1] 王烈宏[1] Liu Yuqin;Li Yongchuan;Ai Xiaoqing;Xing Yue;Ma Ting;Shen Liping;Wang Liehong(Department of Gynaecology,Qinghai Red Cross Hospital,Xining 810000,China)

机构地区：[1]青海红十字医院妇科,西宁810000

出　　处：《中国医师杂志》2019年第1期85-88,共4页Journal of Chinese Physician

摘　　要：目的探讨生物反馈电刺激联合盆底肌训练(PFMT)治疗全子宫切除术后压力性尿失禁(SUI)的临床疗效。方法选取本院妇产科在2014年1月至2017年12月期间接受全子宫切除术且并发SUI者为研究对象,按随机数字表法分为两组:研究组(n=55)采用生物反馈电刺激+PFMT治疗,对照组(n=55)只采用PFMT治疗,两组年龄、BMI、产史和子宫切除诊断构成比、手术方式和SUI诊断分度情况比较差异均无统计学意义(P> 0. 05),记录并比较两组疗效相关指标。结果两组治疗后3、6个月的指标/评分均较治疗前明显改善(P <0. 05),治疗后3个月:研究组尿垫试验漏尿量少于对照组[(4. 3±1. 2) g vs(5. 7±1. 9) g],Ⅰ/Ⅱ类肌纤维肌力恢复情况好于对照组[Ⅰ类:(3. 5±0. 9)级vs(2. 8±1. 1)级;Ⅱ类:(3. 7±0. 6)级vs (3. 2±1. 2)级],国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)问卷评分优于对照组[(4. 3±1. 1)分vs (6. 6±3. 2)分],差异均有统计学意义(P <0. 05);治疗后6个月:研究组尿垫试验漏尿量少于对照组[(1. 4±0. 7) g vs (2. 6±1. 1)g],Ⅰ/Ⅱ类肌纤维肌力恢复情况好于对照组[Ⅰ类:(4. 2±0. 8)级vs (3. 5±1. 1)级;Ⅱ类:(4. 7±0. 5)级vs (4. 0±0. 9)级],ICI-Q-SF问卷评分优于对照组[(2. 7±1. 4)分vs (4. 5±2. 2)分],差异均有统计学意义(P <0. 05)。结论与PFMT治疗相比,全子宫切除术后SUI患者采用生物反馈电刺激+PFMT治疗后漏尿量更少、盆底肌力恢复更好,且主观症状改善更佳。Objective To explore the clinical efficacy of biofeedback electrical stimulation plus pelvic floor muscle training (PFMT)in the treatment of stress urinary incontinence (SUI)after total hysterectomy.Methods The research objects who underwent total hysterectomy and complicated SUI were selected from January 2014 to December 2017 in our hospital.They were randomly divided into two groups :the study group (n =55)received biofeedback electrical stimulation plus PFMT treatment,while the control group (n =55 )received PFMT treatment only .To record and compare the efficacy related indicators of the two groups.Results The indexes and scores of 3/6 months in the two groups were significantly improvedafter treatment.After 3 months the treatment,the study group had less leakage of urine [(4.3 ±1.2)g vs (5.7 ± 1.9)g ],better recovery of muscle strength of Ⅰ/Ⅱ muscle fibers [(3.5 ±0.9)grade vs (2.8 ±1.1 )grade & (3.7±0.6)grade vs (3.2 ±1.2)grade ],and better score of international consultation on incontinence questionnaire-short form (ICI-Q-SF)questionnaire [(2.7±1.4)vs (4.5 ±2.2)]compared with the control group,with statistically significant difference (P <0.05).After 6 months treatment,compared with the control group,the study group had less leakage of urine pad test [(1.4±0.7)g vs (2.6 ±1.1 )g],better recovery of muscle strength of type Ⅰ/Ⅱ muscle fiber [(4.2 ±0.8)grade vs (3.5 ±1.1 )grade &(4.7 ±0.5)grade vs (4.0±0.9)grade],and better ICI-Q-SF score [(2.7 ±1.4)vs (4.5 ±2.2)](P <0.05).Conclusions Compared with using the PFMT alone,biofeedback electrical stimulation plus PFMT treatment had less leakage,better pelvic floor muscle strength and better subjective symptoms.

关 键 词：子宫切除术 尿失禁 压力性 电刺激疗法 骨盆底 肌力 

分 类 号：R713.42[医药卫生—妇产科学] R711.59[医药卫生—临床医学]