生物反馈训练联合低频电刺激对产后压力性尿失禁疗效及血清学指标的影响  

The effect of biofeedback training combined with low-frequency electrical stimulation on the efficacy and serological indicators of postpartum stress urinary incontinence

作　　者：朱方语 黄程君 喻晓晗 ZHU Fang-yu;HUANG Cheng-jun;YU Xiao-han(Department of Dehabilitation,Jinhua Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院康复科,浙江金华321000

出　　处：《中国妇幼保健》2025年第4期616-621,共6页Maternal and Child Health Care of China

基　　金：浙江省科技厅医药卫生科技计划项目(2021RC025)。

摘　　要：目的探讨生物反馈训练联合低频电刺激对产后压力性尿失禁疗效及血清学指标的影响。方法收集2021年3月—2022年12月金华市中心医院收治的产后压力性尿失禁患者208例,随机分为生物反馈训练组、联合低频电刺激组,每组104例。两组患者均给予生物反馈训练,联合低频电刺激组在此基础上加用低频电刺激治疗,均治疗3个月,将治疗后病情无缓解或加重的患者定义为无效。检测盆底表面肌电Glazer评估指标,记录前静息阶段、后静息阶段、快速收缩阶段、耐力收缩阶段、持续收缩阶段的肌电信号水平;进行盆底肌肌力分级,分为Ⅰ~Ⅴ级,级别越高表示盆底肌肉的功能越好。采用1 h尿垫实验、Ingelman-Sundberg分度法评估患者漏尿情况、尿失禁程度。收集患者空腹肘静脉血,检测血清结缔组织生长因子(CTGF)、弹性蛋白酶抑制剂(Elafin)、基质金属蛋白酶1(MMP-1)浓度。结果治疗后快速收缩阶段、耐力收缩阶段、持续收缩阶段盆底表面肌电均明显高于治疗前,且联合低频电刺激组快速收缩阶段、耐力收缩阶段、持续收缩阶段盆底表面肌电明显高于生物反馈训练组(P<0.05)。治疗后两组患者盆底肌肌力均明显好于治疗前(P<0.01);联合低频电刺激组患者治疗后盆底肌肌力明显优于生物反馈训练组(χ^(2)=18.738,P=0.000)。治疗后两组患者漏尿量、1 h尿垫试纸溢尿量、尿失禁程度明显低于治疗前,且联合低频电刺激组漏尿量、1 h尿垫试纸溢尿量、尿失禁程度明显低于生物反馈训练组(P<0.05)。治疗后两组患者血清CTGF、MMP-1浓度明显低于治疗前,血清Elafin浓度明显高于治疗前(P<0.05);治疗后联合低频电刺激组患者血清CTGF、MMP-1浓度明显低于生物反馈训练组,血清Elafin浓度明显高于生物反馈训练组(P<0.05)。生物反馈训练联合低频电刺激组104例患者中治疗有效93例(89.42%)、无效11例(10.58%)。治疗前�Objective To explore the therapeutic effect and serological indicators of biofeedback training combined with low-frequency electrical stimulation on postpartum stress urinary incontinence.Methods 208 postpartum stress urinary incontinence patients admitted to Jinhua Central Hospital from March 2021 to December 2022 were collected and randomly divided into a biofeedback training group and a combined low-frequency electrical stimulation group,with 104 cases in each group.Both groups of patients were given biofeedback training,and the combined low-frequency electrical stimulation group was treated with low-frequency electrical stimulation on top of this for 3 months.Patients whose condition did not improve or worsened after treatment were defined as ineffective.Detect the pelvic floor surface electromyography Glazer evaluation index,record the electromyographic signal levels during the pre resting stage,post resting stage,rapid contraction stage,endurance contraction stage,and sustained contraction stage;Perform pelvic floor muscle strength grading,divided into gradesⅠtoⅤ,with higher grades indicating better pelvic floor muscle function.The 1-hour urine pad test and Ingelman Sundberg grading method were used to evaluate the patient's urinary leakage and degree of uri nary incontinence.Collect fasting elbow vein blood from patients and measure serum levels of connective tissue growth factor(CTGF),elastase inhibitor(Elafin),and matrix metalloproteinase-1(MMP-1).Results The pelvic floor surface electromyography during the rapid contraction stage,endurance contraction stage,and sustained contraction stage after treatment were significantly higher than before treatment,and the pelvic floor surface electromyography during the rapid contraction stage,endurance contraction stage,and sustained contraction stage in the combined low-frequency electrical stimulation group was significantly higher than that in the biofeedback training group(P<0.05).After treatment,the pelvic floor muscle strength of both groups of patients w

关 键 词：压力性尿失禁 产后 生物反馈训练 低频电刺激 结缔组织生长因子 弹性蛋白酶抑制剂 基质金属蛋白酶1 

分 类 号：R714.6[医药卫生—妇产科学]