围绝经期女性压力性尿失禁的康复疗效观察

An observation of therapeutic effect of rehabilitation treatment for SUI of perimenopausal women

目的观察联合外用雌激素软膏和盆底功能锻炼康复对围绝经期女性压力性尿失禁的治疗效果。方法将90例45～55岁围绝经期压力性尿失禁妇女随机分为3组，分别接受盆底功能锻炼康复（组1）、雌激素软膏外用（组2）和盆底功能锻炼康复联合雌激素软膏外用（组3）的治疗方法，随访治疗后3个月的疗效，并对有关数据进行统计分析。结果①治疗后3个月，各组尿失禁量均比治疗前明显减少（t分别为28．75、36．49、33．25，均P〈0．01），组1（2．48±1．20g）与组3（1．84±1．62g）治疗后尿失禁量少于组2（4．25±2．42g）；②组1总有效率高于组2（96．67％VS70．00％；χ2=7．68，P〈0．01），组3总有效率高于组2（100．00％vs70．00％，P=0．00）；③治疗后3个月与治疗前比较，3组Kupperman评分均明显减低，其中组2（16．80±4．21）、组3（16．23±3．38）评分均低于组1（38．41±6．82，t值分别为14．81、15．99，均P〈0．01）。结论单用盆底功能锻炼康复对改善尿失禁效果明显，单用雌激素软膏外用可有效减轻围绝经期症状，盆底功能锻炼康复联合雌激素软膏外用不仅可治疗围绝经期女性尿失禁，同时可减轻围绝经期症状。

Objective To observe therapeutic effect of combination of pelvic floor muscle training（PFMT） with topical estrogen ointment （TEO） for stress urinary incontinence （SUI） of perimenopausal women. Methods 90 perimenopausal women with SUI aged 45-55 years were randomly divided into three groups： group Ⅰ （PFMT alone group）, group Ⅱ （TEO alone group） and group Ⅲ（ PFMT and TEO combined treatment group）. After three months of treatment, the therapeutic effects were compared among the three groups. The data were analyzed statistically. Results 0）After three months of treatment, the amount of urinary incontinence of postmenopansal women in the three groups was all decreased significantly （t =28.75, 36.49, 33.23 respectly, all P 〈0.01 ）. After treatment , the amounts of urinary incontinence in group I （2.48 ＋ 1.20g） and group III（ 1.84 ＋ 1.62g） w.ere lower than that in group II （4.25 ＋ 2.42g） ;~）The total effective rate in group I was higher than that in group Ⅱ （96.67% vs 70.00% ,X2 = 7.68,P 〈 0. 01 ）. And the total effective rate in group Ⅲ was higher than that in group Ⅱ （ 100.00% vs 70.00% ,P =0.00） ;（3）After three months of treatment, the mean Kupperman score in all three groups was lower than that before the treatment, of which, the mean Kupperman scores in group Ⅱ（ 16.80± 4.21 ） and group Ⅲ（ 16.23±3.38） were both lower than that in group Ⅰ （38.42 ± 6.82） （t = 14.81, 15.99 respectively, both P 〈 0.01 ）. Conclusion PFMT could greatly improve SUI of perimenopausal women. TEO could effectively remiss menopausal symptoms. While PFMT and TEO combined treatment could not only treat SUI, but also remiss menopausal symptoms of the posmenopausal women.