腹横肌与盆底肌同步收缩锻炼对围绝经期妇女压力性尿失禁的影响

Effect of co-contraction of transverse abdominal and pelvic floor muscle exercises on stress urinary incontinence of peri-menopausal women

目的观察腹横肌(transverse abdominal muscle,TAM)与盆底肌(pelvic floor muscle,PFM)同步收缩的锻炼方法对围绝经期女性压力性尿失禁(stress urinary incontinence,SUI)的治疗效果。方法选择2014年1月至2016年10月在解放军第306医院妇产科门诊确诊为SUI的围绝经期女性42例,用随机数字表法将其分为两组,各21例,观察组行TAM和PFM同步收缩锻炼,对照组行传统PFM收缩锻炼,锻炼时长为12周;用超声检查比较两组患者锻炼前后在静息状态、TAM最大收缩状态、PFM最大收缩状态、TAM-PFM同步最大收缩状态等4种情况下TAM的厚度变化,并评估患者SUI的转归。结果观察组锻炼后TAM厚度在TAM最大收缩状态和TAM-PFM同步最大收缩状态下均较锻炼前显著增加,差异有统计学意义(P<0.05),静息状态和PFM最大收缩状态下TAM的厚度在锻炼前后比较差异无统计学意义(P>0.05);对照组锻炼前后TAM厚度比较差异无统计学意义(P>0.05);观察组SUI临床治愈率(81.0%)显著高于对照组(42.9%)(P<0.05)。结论 TAM-PFM同步收缩锻炼有助于增加TAM在收缩状态下的厚度,并能提高围绝经期SUI妇女的临床治愈率。

Objective To observe the therapeutic effect of simultaneous contraction of transverse abdominal muscle（TAM） and pelvic floor muscle（PFM） on stress urinary incontinence （SUI） in peri -menopausal women. Methods 42 peri -menopausal women diagnosed as SUI in the 306th Hospital of People＇s Liberation Army from January 2014 to October 2016 were selected. They were divided into two equal groups using the random number table. The observation group took the TAM and PFM co - contraction exercises and the control group performed the traditional PFM contraction exercises. The exercising period was 12 weeks. The thickness of TAM under 4 conditions, including at rest, maximal contraction of PFM, maximal contraction of TAM, and maximal co - contraction of both muscles, were measured before and after exercise through ultrasound. The SUI outcomes and prognosis of these patients were also evaluated. Results In the observation group, there were significant increase in the thickness of TAM of the maximal individual contraction and maximal co - contraction after the exercises than before（P 〈 0. 05）. However, there were no significant changes in the rest and maximal contraction of PFM conditions（P 〉 0. 05）. The differences of the thickness of TAM in the control group were also not significant. The clinical cure rate of SUI in the observation group was 81.0 %, which was significantly higher than that of the control group（42.9 % ） （P 〈 0. 05）. Conclusion The TAM and PFM co- contraction exercise can contribute to increase the thickness of the TAM in contraction status, and may improve the clinical cure rate of SUI in peri - menopausal women.