生物反馈盆底电刺激联合盆底肌训练治疗产后压力性尿失禁效果分析

Effect analysis of biofeedback pelvic floor electrical stimulation combined with pelvic floor muscle training on postpartum stress urinary incontinence

目的观察产后压力性尿失禁(Postpartum stress urinary incontinence,PSUI)患者接受生物反馈盆底电刺激联合盆底肌训练治疗后的效果。方法选择2018年8月至2020年6月本院妇产科收治的PSUI患者106例,随机分为对照组和观察组各53例,对照组单纯采用生物反馈盆底电刺激治疗,观察组在对照组基础上联合盆底肌训练法,两组患者均治疗60d。对比两组患者临床效果、盆底肌表面电信号肌力情况、排尿情况及尿流率参数。结果观察组总有效率高于对照组(P<0.05);观察组治疗后盆底肌力明显改善,肌力评级结果优于对照组(P<0.05);与治疗前比较,两组患者治疗后Ⅰ、Ⅱ类盆底肌纤维电位升高,日平均单次尿量升高,日平均排尿次数及日平均尿失禁次数降低,最大尿流率(Qmax)、平均尿流率(Qave)升高,排尿时间(VT)、尿流时间(FT)、残余尿(RV)、最大尿流率达峰时间(TQamx)降低(均P<0.05),观察组患者治疗后上述指标改善趋势均优于对照组(P<0.05)。结论PSUI患者采用生物反馈盆底电刺激联合盆底肌训练治疗效果确切、安全,有助于提高生物反馈盆底电刺激治疗中肌电水平,改善盆底肌肌力情况与尿动力学,缓解尿失禁症状,值得临床推广应用。

Objective To observe the effect of biofeedback pelvic floor electrical stimulation combined with pelvic floor muscle training on postpartum stress urinary incontinence(PSUI).Methods A total of 106 patients with PSUI from August 2018 to June 2020 in our hospital were randomly divided into control group and observation group,with 53 cases in each group.The control group was treated with biofeedback pelvic floor electrical stimulation,while the observation group was treated with pelvic floor muscle training on the basis of the control group.Both groups were treated for 60 days.The clinical effect,pelvic floor muscle surface electrical signal muscle strength,urination,uroflow parameters were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The pelvic floor muscle strength of the observation group was significantly improved after treatment,and the muscle strength rating results of the observation group were better than those of the control group(P<0.05).Compared with before treatment,the pelvic floor muscle fiber potential of type I and II increased,the daily average single urine volume increased,the daily average micturition times and the daily average urinary incontinence times decreased,the large urine flow rate(Qmax)and average urine flow rate(Qave)increased,and the peak time(VT),urine flow time(FT),residual urine(RV)and maximum urine flow rate(TQamx)increased in the two groups after treatment(all P<0.05).The above indicators in the observation group were better than those of the control group(P<0.05).Conclusion Biofeedback pelvic floor electrical stimulation combined with pelvic floor muscle training is effective and safe for postpartum stress urinary incontinence patients.It is helpful to improve the level of electrical signal muscle strength in biofeedback pelvic floor electrical stimulation treatment,improve the muscle strength and urodynamics of pelvic floor muscle,and relieve the symptoms of urinary incontinence.It is worthy of clinical application.