盆底肌电刺激和凯格尔运动治疗老年女性尿失禁疗效比较

Study of pelvic floor electrical stimulation and Kegel exercises in treatment of elderly women with urinary incontinent

目的:评价盆底肌电刺激(PFES)和凯格尔运动(KE)治疗老年女性尿失禁的疗效,探讨PFES是否为老年女性尿失禁可取的治疗措施。方法:44例老年女性尿失禁患者随机分为两组,22例接受隔日1次的PFES,22例每天进行KE。PFES组采用神经肌肉电刺激治疗仪,皮肤表面电极;KE组每日两次做缩肛运动。总疗程16周。客观疗效评价指标:①漏尿量(标准尿垫试验);②尿动力学检查。主观疗效评价指标:病人自身对尿失禁改善的评价。结果:PFES组主观满意率高达91%,显著高于KE组(64%);PFES组和KE组治疗前后24 h尿垫试验改善的差异无统计学意义,但PFES组漏尿减少50%以上的发生率为77.3%,显著高于KE组(40.9%)。PFES组治疗后valsalva漏尿点压(VLPP)和最大尿道闭合压(MCP)的增加显著高于KE组。结论:PFES能有效治疗老年女性尿失禁,但长期疗效仍需进一步观察。

Objective： To evaluate the effective of pelvic floor electrical stimulation （PFES） and Kegel exercises （KE） on elderly women with urinary incontinence. Methods： In total, forty- four women were enrolled in a randomized clinical trial, a half of them treated with every - other - day PFES and the other women treated with a daily KE program. The duration of both PFES and KE were 16 weeks. Urinary leakage （during a standardized PAD test）, urodynamie study and subjective assessment of change in urinary symptoms were carried out on all women before and after treatment. Results： Significant improvement of subjective assessment was observed in PFES group compared with KE group （91% vs 64% ）. No significant improvement was observed between two groups in PAD test, the catabatic episode of urinary leakage more than 50% occurred 77. 3% in PFES group, significantly higher than that in KE group （40. 9% ）. Significant improvement of both valsalva leak point pressure （VLPP） and max urethral closure pressure （MCP） in PFES group were observed compared with those in KE group. Conclusion： There is better effective on elder women with urinary by PFES compared by KE.