电刺激联合盆底肌训练治疗压力尿失禁的疗效观察

Efficacy of pelvic floor training and electrical stimulation for patients with stress urinary incontinence

目的探讨观察电刺激联合盆底肌训练治疗压力性尿失禁(SUI)的疗效。方法选取经尿动力学检查证实为SUI患者56例,其中男9例,女47例,平均(46±5)岁。采用盆底生物反馈治疗仪进行电刺激联合盆底肌训练,每次32min,每天1次,6周为1疗程。记录治疗前、后患者排尿日记和尿动力学测定,并随访2个月疗效。结果 56例全部完成治疗。其中尿失禁症状完全消失10例(17%),漏尿点压测定无漏尿发生7例(13%)。治疗后总排尿次数(8±2)次/24h、总漏尿事件次数(7±2)次/24h,显著低于治疗前的(15±4)次/24h、(12±3)次/24h(均P<0.05);最大排尿量、正常尿意膀胱压测定容量、最大膀胱压测定容量、漏尿点压和最大尿道闭合压分别为(256±47)L、(260±48)mL、(277±46)mL、(96±10)cm H2O和(62±7)cm H,显著高于治疗前的(143±35)mL、(135±37)mL、(162±33)mL、(79±12)cm H2O和(54±6)cm H2O,差异有统计学意义(均P<0.05)。治疗结束时和2个月后有效率为91%和88%,差异无统计学意义(P>0.05)。结论电刺激联合盆底肌训练是治疗SUI的一种有效方法。

Objective To investigate the efficacy of pelvic floor electrical stimulation （PFES） and pelvic floor training （PFT） for patients with stress urinary incontinence （SUI）. Methods 56 patients with SUI were confirmed with urodynamic study, including 9 men and 47 women, average age （46±5） years old. PFES and PFT were performed 32rain daily for 6 weeks. Urinary diary was recorded and urodynamic study was performed before and after the treatment. Results All 56 patients completed the treatment. Urinary incontinence leakage disappeared in 10 cases （17%） and 7 cases （13%） in leakage point pres- sure measurement. The voiding frequency （8 ± 2）times/24 h and leakage frequency （7 ± 2）times/24 h after treatment were sig- nificantly lower than before treatment [（15±4）times/24 h, （12＋3）times/24 h, P〈O. 05）]. Maximal voiding volume （256± 47） mL, normal desired cystometric capacity（260 ± 48） mL, maximal cystometric capacity （277 ± 46） mL, Vatsalva leak point pressure（96± 10）cm Hz O and maximal urethral closure pressure（62± 7）cm Hz O after treatment were significantly higher than before treatment[（143±35）mL, （135±37）mL, （162±33）mL, （79±12）cm HzO and （54±6）cm H20, P〈O. 05）]. The effec- tive rates immediately after treatment and 2 months after follow-up were 88% and 91%, P〉O. 05. Conclusion Pelvic floor electrical stimulation and pelvic floor training is a useful therapy for patients with SUI.