绝经后妇女压力性尿失禁的非手术治疗研究

Study on nonsurgical therapies for postmenopausal women's stress urinary incontinence

目的 探讨绝经后妇女轻中度压力性尿失禁(SUI)非手术治疗的方法和效果。方法 以随机配对研究方法将绝经后妇女轻中度压力性尿失禁分为使用结合型雌激素(商品名:倍美力)软膏阴道给药配合盆底肌肉锻炼组(A组)、单用倍美力软膏组(B组)、盆底肌肉锻炼组(C组) ,治疗4个月,分析三种方法治疗绝经后妇女压力性尿失禁的临床疗效。结果 使用倍美力软膏阴道给药配合盆底肌肉锻炼组漏尿症状减轻有效率为87 9% ,治疗前后尿失禁量明显减少,差异有显著意义(P <0 . 0 0 1) ;盆底肌肉锻炼组漏尿症状减轻有效率为6 0 . 6 % ,治疗前后尿失禁量明显减少,差异有显著意义(P <0 . 0 0 1) ;单用倍美力软膏阴道给药组漏尿症状减轻仅为2 1. 2 % ,治疗前后尿失禁量减少差异无显著意义(P >0 . 0 5 )。结论 绝经后妇女轻中度压力性尿失禁通过补充雌激素配合盆底肌肉锻炼非手术治疗可改善漏尿症状,方法简单、安全,值得临床推广应用。

Objective To study on therapeutic effect of nonsurgical therapies for postmenopausal women's stress urinary incontinence(SUI).Methods 99 patients with postmenopausal women's SUI were studied from Jan. 2001 to Dec. 2004.In matched survey method,we analyzed therapeutic effects of premarin cream to the vaginal wall combined with pelvic floor muscle exercises(A group),premarin cream monotherapy(B group) and pelvic floor muscle exercises(C group).Results In premarin cream to the vaginal wall combined with pelvic floor muscle exercises group,relief rate of leakage urine was 87.9% and the volume of urinary incontinence decreased obviously after treatment(P<0.001);In pelvic muscle floor exercises group,effective rate for leakage urine was 60.6%,and the volume of urinary incontinence decreased obviously after treament(P<0.001);In premarin cream to the vaginal wall monotherapy group,relief rate of leakage urine was only 21.2%,and the volume of urinary incontinence had no significant difference between pre and post treatment(P>0.05).Conclusions Premarin cream to the vaginal wall combined with pelvic floor muscle exercises(PFME) had a marked therapeutic effect for postmenopausal women's SUI,and was proved to be a simple and safe method,so it is worth popularizing in clinic.