盆底肌训练联合肌电生物反馈在前列腺癌根治术后尿失禁患者中的应用研究  

Application study of pelvic floor muscle training combined with electromyographic biofeedback in urinary incontinence patients after radical prostatectomy

作　　者：高成菲 顾婕 马倩云 任凭 孟宪丽 陆雪 彭春雪 曹洁 GAO Chengfei;GU Jie;MA Qianyun;REN Ping;MENG Xianli;LU Xue;PENG Chunxue;CAO Jie

机构地区：[1]海军军医大学第一附属医院泌尿外科,上海市200433 [2]海军军医大学第一附属医院护理处,上海市200433

出　　处：《中华护理杂志》2025年第4期418-424,共7页Chinese Journal of Nursing

基　　金：国家自然科学基金(81903182);海军军医大学深蓝护理科研项目(2022KYD09)。

摘　　要：目的探究盆底肌训练联合肌电生物反馈在前列腺癌根治术后尿失禁患者中的应用效果,旨在为临床护理实践提供借鉴。方法采用便利抽样法,选取在上海市某三级甲等医院尿失禁护理门诊就诊的98例前列腺癌根治术后尿失禁患者作为研究对象。2022年11月—2023年2月的49例患者作为试验组,接受居家盆底肌训练及门诊肌电生物反馈治疗;2022年6月—9月的49例患者作为对照组,仅进行居家盆底肌训练。两组均接受为期3个月的干预,并在治疗前由失禁专科护士提供盆底肌训练指导。术后拔除导尿管当日及干预后的1、2、3个月,通过24 h尿垫试验的漏尿量、国际尿失禁咨询委员会尿失禁问卷简表(International Consultation on Incontinence Questionnaire-Short Form,ICIQ-SF)、尿失禁生活质量问卷(Incontinence Quality of Life Questionnaires,I-QOL)以及盆底肌肉锻炼自我效能量表(Broome Pelvic Muscle Self-efficacy Scale,BPMSES)分别评估患者的尿失禁客观严重程度、主观严重程度、生活质量及盆底肌训练自我效能。结果两组各纳入患者46例。两组24 h漏尿量和I-QOL得分的组间效应和时间效应差异均有统计学意义(P<0.05),组间和时间无交互效应(P>0.05)。两组ICIQ-SF和BPMSES得分的时间和组间存在交互效应,差异具有统计学意义(P<0.05),干预后2、3个月,试验组的ICIQ-SF得分低于对照组,差异具有统计学意义(P<0.001),试验组的BPMSES得分高于对照组,差异具有统计学意义(P<0.05)。结论盆底肌训练联合肌电生物反馈能有效改善前列腺癌根治术后患者尿失禁的主客观严重程度,提升患者的自我效能感和生活质量。Objective To investigate the rehabilitative effects of pelvic floor muscle training(PFMT)combined with electromyography biofeedback(EMG-BF)in patients with post-prostatectomy incontinence(PPI),aims to provide reference for clinical nursing practice.Methods 98 patients with PPI who were treated at the urinary incontinence nurse-led clinic of a tertiary hospital in Shanghai were included using the method of convenience sampling.Patients enrolled from June to September 2022 were assigned to a control group(n=49),receiving PFMT alone at home.Those enrolled from November 2022 to February 2023 were assigned to an experimental group(n=49),receiving PFMT at home combined with EMG-BF at the nurse-led clinic.Both groups received intervention for 3 months,preceded by guidance for PFMT provided by incontinence specialist nurses.The urine leakage in 24-hour pad test,the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF),the Incontinence Quality of Life Questionnaires(I-QOL),and the Broome Pelvic Muscle Self-Efficacy Scale(BPMSES)were used to assess objective and subjective incontinence severity,quality of life,and self-efficacy of PFMT on the day of catheter removal and at 1,2,and 3 months post-intervention.Results A total of 46 patients were included in each group.The 24-hour urine leakage volume and I-QOL scores demonstrated significant between-group and over-time effects(P<0.05),with no interaction effect between groups and time(P>0.05)The ICIQ-SF and BPMSES scores exhibited interactive effects between time and groups(P<0.05).At 2 and 3 months post-intervention,the intervention group showed significantly lower ICIQ-SF scores(P<0.001),and higher BPMSES scores(P<0.05),compared to those in the control group.Conclusion PFMT combined with EMG-BF can effectively alleviate the objective and subjective severity of PPI,enhance patients’self-efficacy in PFMT,and improve their postoperative quality of life.

关 键 词：盆底肌训练 肌电生物反馈 前列腺癌根治术 尿失禁 护理 

分 类 号：R473.73[医药卫生—护理学]