经颅重复刺激联合运动治疗在压力性尿失禁盆底康复治疗中的应用价值

Application value of transcranial repetitive stimulation combined with exercise therapy in pelvic floor rehabilitation of stress urinary incontinence

目的分析经颅重复刺激联合运动治疗在压力性尿失禁盆底康复治疗中的应用价值。方法将我院2019年1月至2022年12月收治的80例压力性尿失禁患者以不同治疗措施分为常规组和观察组,每组40例。常规组给予常规运动治疗,观察组在常规组治疗基础上增加经颅重复刺激治疗。比较两组的治疗效果。结果观察组的盆底肌力恢复优良率高于常规组(P<0.05)。治疗后,观察组的国际尿失禁咨询委员会尿失禁问卷表简表(ICIQ-SF)评分低于常规组,膀胱颈下移距离、膀胱尿道后角、盆底裂孔面积及膀胱颈至耻骨联合下缘距离优于常规组(P<0.05)。治疗后,观察组的盆底前静息值、后静息值、快速收缩最大值、紧张收缩值及残余尿量(RUV)低于常规组,耐力收缩值、最大尿道闭合压(MUCP)、充盈期逼尿肌压力(Pdet-Q_(max))、强烈尿感容量(SD)、最大尿流率(Q_(max))高于常规组(P<0.05)。结论经颅重复刺激联合运动治疗用于压力性尿失禁盆底康复治疗中可快速恢复盆底肌力与解剖结构,并改善尿动力障碍。

Objective To analyze the application value of transcranial repetitive stimulation combined with exercise therapy in pelvic floor rehabilitation of stress urinary incontinence.Methods A total of 80 patients with stress urinary incontinence admitted in our hospital from January 2019 to December 2022 were divided into routine group and observation group according to different treatment measures,with 40 cases in each group.The routine group was given routine exercise therapy,and the observation group was treated with transcranial repetitive stimulation on the basis of the routine group.The therapeutic effects of the two groups were compared.Results The excellent and good rate of pelvic floor muscle strength recovery in the observation group was higher than that in the routine group(P<0.05).After treatment,the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form(ICIQ-SF)score of the observation group was lower than that of the routine group,and the distance of bladder neck down,area of posterior horn of bladder urethra,pelvic floor hiatus and the distance of bladder neck to the lower edge of pubic symphysis were better than those of the routine group(P<0.05).After treatment,the pre-rest value,post-rest value,maximum rapid contraction value,tension contraction value of the pelvic floor and residual urine volume(RUV)in the observation group were lower than those in the routine group,and the endurance contraction value the maximum urethral closure pressure(MUCP),pressure of detrusor at Qmax(Pdet-Q_(max)),strong urine sensation volume(SD)and maximum flow rate(Q_(max))were higher than those in the routine group(P<0.05).Conclusion Transcranial repetitive stimulation combined with exercise therapy for pelvic floor rehabilitation of stress urinary incontinence can quickly restore pelvic floor muscle strength and anatomical structure,and improve urodynamic disorders.