盆底肌电刺激联合Kegel盆底肌锻炼治疗产后尿失禁的效果及对盆底肌张力的影响

Effects of pelvic floor muscle electrical stimulation combined with Kegel pelvic floor muscle exercise in the treatment of postpartum urinary incontinence and its influence on pelvic floor muscle tension

目的 探究盆底肌电刺激联合Kegel盆底肌锻炼治疗产后压力性尿失禁(SUI)的效果及对盆底肌张力的影响。方法 选择2020年1月至2022年1月西北妇女儿童医院收治的产后SUI患者128例纳入研究,根据随机数表法分为对照组和观察组各64例,对照组患者进行Kegel盆底肌锻炼治疗,观察组患者进行盆底肌电刺激联合Kegel盆底肌锻炼治疗,治疗8周,比较两组患者疗程结束时的疗效以及治疗前后的尿动力学、盆底肌张力及性功能的差异。结果 观察组患者治疗总有效率为92.19%,明显高于对照组的79.69%,差异有统计学意义(P<0.05);观察组患者治疗后的最大尿道闭合压、腹压漏尿点压、平均尿流率水平分别为(8.19±1.27) k Pa、(12.18±2.36) kPa和(14.46±2.59) kPa,明显高于对照组的(7.24±1.13) kPa、(10.09±2.12) kPa和(11.94±2.52) kPa,差异均有统计学意义(P<0.05);观察组患者治疗后的手测肌力(Oxford Scale法)、Ⅰ类盆底肌力、Ⅱ类盆底肌力分别为(3.76±0.61)分、(31.48±6.12)μV、(39.42±11.47)μV,明显大于对照组的(3.32±0.74)分、(28.19±5.10)μV、(33.49±9.22)μV,差异均有统计学意义(P<0.05);观察组患者治疗后的女性性功能量表(FSFI)评分为(30.32±8.79)分,明显高于对照组的(26.73±6.51)分,差异有统计学意义(P<0.05)。结论 盆底肌电刺激联合Kegel盆底肌锻炼治疗产后SUI疗效确切,其不仅能够有效改善患者尿流动力学、增加盆底肌张力,而且还有利于提高患者性功能。

Objective To explore the effects of pelvic floor muscle electrical stimulation combined with Kegel pelvic floor muscle exercise in the treatment of postpartum stress urinary incontinence(SUI)and its influence on pelvic floor muscle tension.Methods A total of 128 patients with postpartum SUI treated in Northwest Women'and Children's Hospital between January 2020 and January 2022 were selected and divided into a control group and an observation group according to random number table method,with 64 cases in each group.Patients in the control group received Kegel pelvic floor muscle exercise,while patients in the observation group were given pelvic floor muscle electrical stimulation combined with Kegel pelvic floor muscle exercise,both for 8 weeks.The efficacy at the end of course of treatment and urodynamic examination results,pelvic floor muscle tension and sexual function before and after treatment were compared between the two groups of patients.Results The total effective rate of treatment was 92.19%in the observation group,significantly higher than 79.69%in the control group(P<0.05).The maximum urethral closure pressure,abdominal leak point pressure,and average urine flow rate after treatment were(8.19±1.27)KPa,(12.18±2.36)KPa,and(14.46±2.59)KPa in the observation group,which were significantly higher than(7.24±1.13)KPa,(10.09±2.12)KPa,and(11.94±2.52)KPa in the control group(P<0.05).The manual muscle strength(Oxford Scale method),typeⅠpelvic floor muscle strength,and typeⅡpelvic floor muscle strength in the observation group after treatment were(3.76±0.61)points,(31.48±6.12)μv,and(39.42±11.47)μv,which were significantly higher than(3.32±0.74)points,(28.19±5.10)μv,and(33.49±9.22)μV in the control group(P<0.05).After treatment,the score of Female Sexual Function Index(FSFI)in the observation group was(30.32±8.79)points,which was significantly higher than(26.73±6.51)points in the control group(P<0.05).Conclusion Pelvic floor muscle electrical stimulation combined with Kegel pelvic floor muscle exercise has an exact efficacy in the treatment of postpartum SUI.It can not only effectively improve the urodynamics and increase the pelvic floor muscle tension,but also help enhance the sexual function of patients.