负压治疗联合盆底肌训练对前列腺癌根治术后患者控尿功能及性功能的影响

Effects of negative pressure therapy combined with pelvic floor muscle training on urinary continence and sexual function in patients after radical prostatectomy

目的探讨负压治疗联合盆底肌训练对前列腺癌根治术后患者控尿功能及主观幸福感的影响。方法将中山大学附属第三医院2016年10月至2019年4月泌尿外科确诊为前列腺癌并行腹腔镜下前列腺癌根治术治疗的70例患者,按随机数字表法分为干预组和对照组各35例,其中对照组35例采用常规护理(盆底肌功能锻炼),干预组35例在常规护理基础上,术后6周起再增加负压治疗。比较对照组和干预组术后6周、10周、18周控尿功能恢复情况,同时进行国际勃起功能评分表(IIEF-5)评分及主观幸福感调查,观察其治疗效果。结果干预组术后6周、10周、18周尿失禁评分中位值分别2分、1分与0分,低于对照组的2分、2分与2分,提示干预组术后平均控尿功能恢复时间较对照组短,差异有统计学意义(P<0.05);此外干预组相比对照组,IIEF-5评分及主观幸福感评分上升速度较快,提示干预组术后勃起功能和生活质量改善情况明显优于对照组。结论负压治疗联合盆底肌训练对前列腺癌根治术后患者的控尿功能和性功能有明显改善,且缩短其恢复时间。

Objective To investigate the effect of negative pressure treatment combined with pelvic floor muscle training on urinary continence and sexual function of patients with prostate cancer(PCa)after radical prostatectomy.Methods From October 2016 to April 2019,in the Third Affiliated Hospital of Sun Yat-sen University 70 patients were diagnosed with prostate cancer and underwent laparoscopic radical prostatectomy.According to the random number table method,they were divided into intervention group and control group,35 cases each.The control group of 35 patients received routine nursing(pelvic floor muscle functional exercise),and the intervention group of 35 patients underwent routine nursing,and then increased negative pressure exercise therapy from six weeks after surgery.The urinary continence were compared at 6 weeks,10 weeks,and 18 weeks.At the same time,the International Erectile Function Scale(IIEF-5)score and subjective well-being survey were conducted to observe the treatment effect.Results The median scores of urinary incontinence at 6 weeks,10 weeks,and 18 weeks in the intervention group were 2,1 and 0,respectively,which were significantly lower than those in the control group.The recovery time of urinary control function was shorter than that of the control group,and the difference was statistically significant(P<0.05);In addition,the intervention group had a faster increase in IIEF-5 score and subjective well-being score than the control group,suggesting that the intervention group had postoperative erectile function.The improvement of the quality of life was significantly better than the control group.Conclusion Negative pressure therapy combined with pelvic floor muscle training can significantly improve the urinary continence and sexual function of patients after radical prostatectomy,shorten their recovery time.