低频神经肌肉刺激治疗轻中度压力性尿失禁的临床研究  

Clinical study of low frequency neuromuscular stimulation for mild to moderate stress urinary incontinence

作　　者：董施秋 高潇[2] 郭静[3] 陈英超[3] 杜林 于靓 杨丹[3] DONG Shiqiu;GAO Xiao;GUO Jing;CHEN Yingchao;DU Lin;YU Liang;YANG Dan(Department of Clinical Medicine,Heilongjiang Nursing College,Heilongjiang Province,Harbin150080,China;Ward One,Department of Geriatric,the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin150080,China;Ward of Gynecological,Harbin First Hospital,Heilongjiang Province,Harbin150010,China)

机构地区：[1]黑龙江护理高等专科学校临床医学系,黑龙江哈尔滨150080 [2]黑龙江中医药大学附属第二医院老年一病房,黑龙江哈尔滨150001 [3]哈尔滨市第一医院妇科病房,黑龙江哈尔滨150010

出　　处：《中国医药导报》2023年第3期71-74,共4页China Medical Herald

基　　金：国家卫生健康委能力建设及继续教育项目(GWJJ2020100102);黑龙江省卫生健康委科研课题(2019-206);黑龙江省教育科学“十四五”规划重点课题(ZJB1421222);黑龙江省博士后项目(LBH-Q21180)。

摘　　要：目的 观察低频神经肌肉刺激治疗轻中度压力性尿失禁的临床效果。方法 全部60例入组女性患者来自2019年10月至2021年5月哈尔滨市第一医院妇科,采用随机数字表法分为对照组30例及治疗组30例。对照组采用单纯盆底肌训练法,治疗组采用低频神经肌肉刺激治疗。治疗15 d后,通过比较两组治疗前后Ⅰ类肌纤维表面肌电与压力值、Ⅱ类肌纤表面肌电与压力值、患者漏尿量、漏尿频次及对患者生活的影响程度进行效果评价。结果 治疗后,两组压力Ⅰ、压力Ⅱ水平高于治疗前,且治疗组高于对照组,差异有统计学意义(P<0.05)。两组肌电Ⅰ、肌电Ⅱ水平高于治疗前,且治疗组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组1 h尿垫试验漏尿量、平均24 h漏尿频次、尿失禁问卷表简表评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。结论 低频神经肌肉刺激治疗可以增肌Ⅰ与Ⅱ类肌纤维表面肌电与压力值,抑制逼尿肌的过度活动,改善轻中度压力性尿失禁患者的临床症状。Objective To observe the clinical effect of low frequency neuromuscular stimulation on mild to moderate stress urinary incontinence. Methods All 60 enrolled female patients were enrolled from Harbin First Hospital from October 2019 to May 2021, they were divided into control group(30 cases) and treatment group(30 cases) by random number table method. The control group was treated by simple pelvic floor muscle training, and the treatment group was treated by low frequency neuromuscular stimulation. After 15 days of treatment, the efficacy was evaluated by comparing the surface electromyography and pressure value of type Ⅰmuscle fibre, surface electromyography and pressure value of type Ⅱmuscle fibre, urine leakage volume, frequency of urine leakage, and the degree of influence on patients’ life before and after treatment. Results After treatment, the levels of stress Ⅰ and stress Ⅱ in both groups were higher than those before treatment, while those of the treatment group were higher than those of the control group, the differences were statistically significant(P<0.05). The levels of electromyography Ⅰ and Ⅱ in both groups were higher than before treatment, while those of the treatment group were higher than those of the control group, and the differences were statistically significant(P<0.05). After treatment, 1 h pad test urine leakage, average 24 h urine leakage frequency and the score of international consultation on incontinence questionnaire urinary incontinence short form of the two groups were lower than before treatment, while those of the treatment group were lower than those of the control group, and the differences were statistically significant(P<0.05).Conclusion Low-frequency neuromuscular stimulation can increase the surface electromyography and pressure values of muscle fibers of type I and Ⅱ, inhibit overactivity of detrusor muscle, and improve the clinical symptoms of patients with mild to moderate stress incontinence.

关 键 词：压力性尿失禁 盆底肌训练 低频神经肌肉刺激 表面肌电 

分 类 号：R47[医药卫生—护理学]