盆底肌锻炼联合经皮神经电刺激治疗前列腺癌根治术后尿失禁的临床研究

Clinical study of pelvic floor muscle exercise combined with transcutaneous electrical nerve stimulation in the treatment of urinary incontinence after radical prostatectomy

目的探讨盆底肌锻炼(PFMT)联合经皮神经电刺激(TENS)干预前列腺癌根治术(RP)后尿失禁的效果。方法回顾性选取2020年7月—2021年6月上海中医药大学附属曙光医院收治的RP术后尿失禁患者120例,根据治疗方法不同将其分为对照组和观察组,每组各60例。对照组患者采用PFMT治疗,观察组患者采用PFMT联合TENS治疗。比较两组患者的72 h尿垫使用量、最大尿流率、最大膀胱容量、最大尿道闭合压、腹压漏尿点压、尿失禁问卷表简表(ICI-Q-SF)评分以及临床疗效。计量资料以均数±标准差(±s)表示,组间比较采用t检验;计数资料组间比较采用χ^(2)检验。结果治疗后,观察组患者72 h尿垫使用量为(1.95±1.13)片,低于对照组[(6.28±2.47)片],差异具有统计学意义(P<0.05);治疗后,观察组患者的最大尿流率[(13.92±2.53)mL/s]、最大膀胱容量[(338.72±19.22)mL]、最大尿道闭合压[(69.75±5.04)cmH_(2)O]、腹压漏尿点压[(90.56±5.26)cmH_(2)O]均优于对照组[(11.48±2.18)mL/s、(325.81±18.63)mL、(65.29±4.78)cmH_(2)O、(83.58±5.29)cmH_(2)O],差异均具有统计学意义(P<0.05);治疗后,观察组患者的ICI-Q-SF评分[(5.97±1.82)分]低于对照组[(10.95±2.64)分],差异具有统计学意义(P<0.05);观察组患者的临床有效率(93.33%)高于对照组(78.33%),差异具有统计学意义(P<0.05)。结论PFMT联合TENS治疗RP术后尿失禁优于单独应用PFMT。

Objective To investigate the effect of pelvic floor muscle exercise(PFMT)combined with transcutaneous electrical nerve stimulation(TENS)on urinary incontinence after radical prostatectomy.Methods A total of 120 patients with urinary incontinence after radical prostatectomy in Shuguang Hospital,Shanghai University of Traditional Chinese Medicine from July 2020 to June 2021 were retrospective selected and divided into control group and observation groupthe according to different treatment method,60 cases in each group.The control group was treated with PFMT,and the observation group was treated with PFMT combined with TENS.Urodynamic indexes of 72 h urine pad usage,maximum urine flow rate,maximum cystometric capacity,maximum urethral closure pressure,abdominal leakage point pressure,ICI-Q-SF score and the clinical efficacy were compared between the two groups.Measurement data were expressed as mean±standard deviation(±s),and t-test was used for comparison between groups;Chi-square test was used for comparison of enumeration data between groups.Results After treatment,the 72 h urine urine pad usage in the observation group[(1.95±1.13)pieces]was lower than that in the control group[(6.28±2.47)pieces],and the difference was statistically significant(P<0.05).After treatment,the maximum flow rate[(13.92±2.53)mL/s],maximum cystometric capacity[(338.72±19.22)mL],maximum urethral closure pressure[(69.75±5.04)cmH_(2)O],abdominal leakage point pressure[(90.56±5.26)cmH2O]in observation group after treatment were better than those in control group[(11.48±2.18)mL/s,(325.81±18.63)mL,(65.29±4.78)cmH_(2)O,(83.58±5.29)cmH_(2)O],the difference were statistically significant(P<0.05).After treatment,the ICI-Q-SF score of the observation group[(5.97±1.82)points]was lower than that of the control group[(10.95±2.64)points],and the difference was statistically significant(P<0.05);the clinical effective rate of observation group(93.33%)was higher than that of control group(78.33%),and the difference was statistically significant(P<0.05).Conclusion PFMT combined with TENS is better than PFMT alone in the treatment of postoperative urinary incontinence after radical prostatectomy.