不同频率电刺激联合阴道哑铃治疗产后尿失禁的效果分析

Effect of Different Frequencies of Electrical Stimulation Combined with Vaginal Dumbbells on Postpartum Urinary Incontinence

目的探讨不同频率电刺激联合阴道哑铃治疗产后尿失禁的效果。方法新乡市第一人民医院2020年1月至2021年12月收治的产后尿失禁患者200例按照随机数字表法分为2组:A组和B组,各100例,2组均采取阴道哑铃治疗,另A组给予50 Hz频率电刺激,B组给予20 Hz频率电刺激。比较2组尿垫试验结果及治疗前后盆底肌肌力、盆底超声参数(盆膈裂孔面积、尿道长度、膀胱颈位置)、尿动力学[最大尿流率(Qmax)、最大尿道闭合压力(MUCP)、咳嗽漏尿点压力(CLPP)],并随访患者的生活质量(心理影响、行为限制、社会障碍)。结果A组尿垫试验总有效率高于B组(P<0.05);治疗后A组盆底肌肌力、盆底超声参数、Qmax、CLPP、MUCP均优于B组(均P<0.05);治疗后6个月进行随访,A组心理影响、行为限制、社会障碍评分均高于B组(均P<0.05)。结论相比于20 Hz电刺激,50 Hz电刺激联合阴道哑铃有助于提高产后尿失禁患者盆底肌肌力,改善尿动力学和盆底超声参数,提高生活质量。

Objective To investigate the effect of different frequencies of electrical stimulation combined with vaginal dumbbells on postpartum urinary incontinence.Methods Two hundred patients with postpartum urinary incontinence admitted to Xinxiang First People’s Hospital from January 2020 to December 2021 were randomly divided into two groups,with 100 patients in each group.Both groups were treated with vaginal dumbbells.Furthermore,group A and group B were given 50 and 20 Hz electrical stimulation,respectively.Urinary pad test results,pelvic floor muscle strength,pelvic floor ultrasound parameters(pelvic diaphragm hiatus area,urethral length and bladder neck position),and urodynamics(maximum urinary flow rate(Qmax),maximum urethral closure pressure(MUCP)and cough leak point pressure(CLPP))were compared between the two groups.The patients were followed up for the quality of life,including psychological impacts,behavioral limitations and social barriers.Results The total effective rate of urinary pad test in the group A was higher than that in the group B(P<0.05).After treatment,pelvic floor muscle strength,pelvic floor ultrasound parameters,Qmax,CLPP and MUCP in the group A were better than those in the group B(P<0.05).At 6 months after treatment,the scores of psychological impacts,behavioral limitations and social barriers in the group A were higher than those in the group B(P<0.05).Conclusion Compared with 20 Hz electrical stimulation,the combination of 50 Hz electrical stimulation and vaginal dumbbells can improve pelvic floor muscle strength,urodynamics,pelvic floor ultrasound parameters and quality of life in patients with postpartum urinary incontinence.