肌电生物反馈联合骶四针治疗老年患者前列腺电切术后压力性尿失禁的临床研究

Myoelectric Biofeedback Combined with Four Sacral Needles in the Treatment of Older Patients with Stress Urinary Incontinence after Electrosurgical Prostatectomy

目的探讨肌电生物反馈联合骶四针对老年患者前列腺电切术后压力性尿失禁的疗效。方法选取2015年12月~2019年12月首都医科大学附属北京康复医院收治的前列腺增生患者98例,随机数表法分为对照组49例和实验组49例。所有患者接受2μm铥激光汽化前列腺切除术,术后口服索利那新及坦索罗辛,实验组在此基础上辅以肌电生物反馈联合骶四针治疗。比较两组患者术后尿失禁发生率、排尿指标及生活质量评分。结果实验组术后2周及3个月尿失禁发生率与对照组相比差异均无统计学意义(P>0.05),实验组术后1个月尿失禁发生率低于对照组(P<0.05);实验组术后最大尿流率(Qmax)、最大逼尿肌压力(MDP)高于对照组,残余尿量(PVR)低于对照组,差异均有统计学意义(P<0.05);实验组术后国际前列腺症状评分(IPSS)及生活质量评分(QOL)均低于对照组,差异有统计学意义(P<0.01)。结论肌电生物反馈联合骶四针相比对照组能有效改善老年前列腺电切术后患者排尿情况及生活质量。

Objective To investigate the effect of myoelectric biofeedback combined with four sacral needles on elderly patients with stress urinary incontinence after electrosurgical prostatectomy.Methods 98 patients with benign prostatic hyperplasia admitted in Beijing Rehabilitation Hospital of Capital Medical University were enrolled from December 2015 to December 2019.The patients were divided into the control group(49 cases)and the experimental group(49 cases)by random number table method.All patients underwent 2μm thulium laser vaporized prostatectomy and received oral administration of solinacin and tamsulosin.The experimental group received additionally the electromyography biofeedback and four sacral needles treatment after surgery.The incidence of postoperative urinary incontinence,urination index and quality of life were compared between the two groups.Results There was no significant difference in the incidence of urinary incontinence at 2 weeks and 3 months after surgery between the two groups(P>0.05).The incidence of urinary incontinence in the experimental group 1 month after surgery was lower than that in the control group(P<0.05).The postoperative Qmax and maximal detrusor pressure(MDP)were higher,post-void residual volume(PVR)was lower in the experimental group than those in the control group(P<0.05).The postoperative international prostate symptom score(IPSS)score and quality of life(QOL)score in the experimental group were lower than those in the control group(P<0.01).Conclusion The myoelectric biofeedback combined with four sacral needle might effectively improve the urination and quality of life of elderly patients after electrosurgical prostatectomy.