盆底治疗仪联合盆底肌锻炼在剖宫产产后压力性尿失禁患者中的应用效果

Effects of pelvic floor therapy instrument combined with pelvic floor muscle exercise in application of patients with stress urinary incontinence after cesarean section

目的:观察盆底治疗仪联合盆底肌锻炼在剖宫产产后压力性尿失禁(SUI)患者中的应用效果。方法:选取2020年1月至2022年8月该院收治的106例剖宫产产后SUI患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各53例。对照组采用盆底肌锻炼,研究组在对照组基础上采用盆底治疗仪治疗。比较两组临床疗效、治疗前后盆底肌力、尿动力学指标[最大尿流率(Qmax)、最大尿道闭合压(MUCP)、腹部漏尿点压(ALPP)]水平、生命质量[尿失禁生活质量量表(I-QOL)]评分和不良反应发生率。结果:研究组治疗总有效率为92.45%(49/53),高于对照组的77.36%(41/53),差异有统计学意义(P<0.05);治疗后,两组盆底肌肌力分级均优于治疗前,且研究组优于对照组,差异有统计学意义(P<0.05);两组Q_(max)、MUCP、ALPP水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组逃避和限制性行为、心理社会影响、社会活动受限等I-QOL评分均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗期间,两组均未发生明显不良反应。结论:盆底治疗仪联合盆底肌锻炼应用于剖宫产产后SUI患者可提高治疗总有效率、尿动力学指标水平和生命质量评分,改善盆底肌肌力分级,其效果优于单纯盆底肌锻炼。

Objective:To observe effects of pelvic floor therapy instrument combined with pelvic floor muscle exercise in application of patients with stress urinary incontinence(SUI)after cesarean section.Methods:A prospective study was conducted on 106 patients with SUI after cesarean section admitted to this hospital from January 2020 to August 2022.According to the random number table method,they were divided into study group and control group,53 cases in each group.The control group was treated with pelvic floor muscle exercise,while the study group was treated with pelvic floor therapy instrument on the basis of that of the control group.The clinical efficacy,the pelvic floor muscle strength before and after the treatment,the urodynamic indexes[maximum urinary flow rate(Qmax),maximum urethral closure pressure(MUCP),abdominal leak point pressure(ALPP)]levels,the quality of life[urinary incontinence-quality of life scale(I-QOL)]score,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the study group was 92.45%(49/53),which was higher than 77.36%(41/53)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the pelvic floor muscle strength levels of the two groups were better than those before the treatment,that in the study group was better than that in the control group,and the difference was statistically significant(P<0.05).The Q_(max),MUCP and ALPP levels of the two groups were higher than those before the treatment,those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The I-QOL scores of avoidance and restrictive behavior,psychosocial impact and social activity limitation in the two groups were higher than those before the treatment,those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).During the treatment,no obvious adverse reactions occurred in the two groups.Conclusions:Pelvic floor therapeutic instrument combined with pelvic floor muscle exercise can improve the total effective rate of treatment,the urodynamic index levels and the quality of life scores,and improve the pelvic floor muscle strength grading in the patients with SUI after cesarean section.Moreover,it is superior to single pelvic floor muscle exercise.