经产妇自然分娩后压力性尿失禁电刺激治疗的临床效果分析

THE TREATMENT EFFECTS OF ELECTRICAL STIMULATION IN THE TREATMENT OF THE POSTPARTUM URINARY INCONTINENCE FOR MULTIPARA WITH NATURAL DELIVERY

目的探讨经产妇自然分娩后轻度压力性尿失禁电刺激治疗的临床效果。方法选取唐山市妇幼保健院2016年1—10月间收治的自然分娩的经产妇于产后42d伴轻度压力性尿失禁的患者73例进行观察研究,随机分成二组,即对照组36例采用盆底肌肉锻炼方式治疗,观察组37例采用盆底康复仪电刺激联合盆底肌肉锻炼方式治疗。连续治疗6个月后复检,对比二组产妇治疗前后盆底肌分级变化、阴道静息压(VRP)、阴道收缩压(VSP)和阴道收缩持续时间的变化,统计二组患者治疗的总有效率。结果治疗前二组患者盆底肌张力分级比例、VRP、VSP和阴道收缩持续时间差异无统计学意义(P>0.05),治疗6个月后二组产妇盆底肌张力测试Ⅵ~Ⅴ级水平比例明显增加(P<0.05);VRP、VSP和阴道收缩持续时间3项指标改善情况观察组优于对照组(P<0.05);观察组治疗总有效率为94.59%,高于对照组的69.44%(P<0.05)。结论电刺激治疗经产妇自然分娩后压力性尿失禁能够迅速改善患者盆底肌拉力,恢复阴道收缩功能,提升治疗效果。

Objective To investigate the clinical effects of electrical stimulation treating on the postpartum stress urinary incontinence in second childbirth women aftez natural labor. Methods From January 2014 to October 2016,73 cases of women suffering postpartum stress urinary incontinence after 42 days of second natural childbirth were selected for this study in author＇s hospital. The patients were randomly divided into 2 groups,namely the control group （n = 36） and observation group （n = 37）. The patients in control group received the selfexercise of pelvic floor muscle training for 6 months, while the patients in observation group received the pelvic floor muscle enforcement program by electrical stimulation and selfexercise of pelvic floor muscle training. Before and after the treatment, the maternal pelvic floor muscles grading situation,vaginal resting pressure （VRP）,vaginal systolic blood pressure （VSP） and the duration of vaginal contractions were recorded and compared between the 2 groups. Results Before treatment,there were no statistically significant difference between the 2 groups of patients in the pelvic floor muscle tension grading scale, VRP, VSP and duration of the vaginal contractions （P 〉0.05）. After 6 months treatment, both groups of the pelvic floor muscle tension grading scale Ⅰ and Ⅱ were reduced significantly than that of before treatment （P〈 0.05）, and the improvement of VRP, VSP and vaginal constriction duration in the observation group were higher than that in the control group （P〈0.05）. The effective rate of the observation group was higher （94.59%） than that of the control group （69.44%） with statistically significant （x2 = 3.397,P〈0.05）. Conclusion The electrical stimulation treatment on the postpartum urinary incontinence in second childbirth women can effectively improve pelvic floor muscle tension, and restore the sphincter closure mechanism of the urethra.