3种盆底肌肉治疗方式对产后压力性尿失禁患者的治疗效果评估

目的:探讨3种不同的盆底肌肉治疗方式对压力性尿失禁产妇功能恢复临床疗效,寻找非手术治疗方法。方法:选择2014年9月-2016年1月在本院行产后42d检查患有压力性尿失禁的产妇,共118例,产妇随机分为3组,单独电刺激治疗30例(电刺激组);单独场景生物反馈训练治疗共31例(生物组);电刺激联合场景生物反馈训练治疗共46例(联合组)。所有对象治疗前测定的结果为初评,治疗5次为二评,治疗10次为三评。评估3组患者在应用3种不同方法治疗后盆底肌力、疲劳度、肌电位的变化。结果:所有对象二评结果、三评结果Ⅰ类肌力、Ⅱ类肌力均好于初评结果(P均0.05);Ⅰ类肌疲劳度、Ⅱ类肌疲劳度、肌电位差异没有统计学意义(P均0.05)。治疗后3组患者Ⅰ类肌力、Ⅱ类肌力、Ⅰ肌疲劳度、Ⅱ肌疲劳度均没有统计学意义(P均0.05)。联合组和生物组的肌电位均高于电刺激组(P0.05)。结论:3种治疗方式均能够改善患者产后的肌力,患者的自主评分均7分,漏尿程度较治疗前也有明显的改善。建议至少坚持5次盆底功能训练治疗疗效更好,联合组和生物组患者的肌电位最高疗效最好。

Curative effects assessment of three kinds of pelvic floor muscle treatments for puerperae with postnatal stress urinary incontinence

Objective:To explore the clinical curative effects of three kinds of pelvic floor muscle treatments on functional recovery of pelvic floor muscle of puerperae with stress urinary incontinence,and to explore the better non-surgical methods to treat puerperae with stress urinary incontinence.Methods:From September 2014 and January 2016,a total of 107 puerperae with stress urinary incontinence who accepted postpartum 42 day examination were selected and randomly divided into 3 groups.30 puerperae who had received single electrical stimulation was in group A,31 puerperae who had received single scene biofeedback training was in group B,46 patients puerperae who had received electrical stimulation combined with scene biofeedback training was in group C.The determination of values of all puerperae before treatment were the primary screening results,the determination of values of all puerperae after treatment for 5 times were secondary screening results,and the determination of values of all puerperae after treatment for 10 times were the third screening results.The change of screening results of puerperae after three different treatments were evaluated on the muscles strength,fatigue and muscle potential of the pelvic bottom.Results:The results showed that compared to the primary screening results,there were statistically significant differences in the level Ⅰ muscle strength and level Ⅱ muscle strength of secondary screening results and third screening results of puerperae (P＜0.05),but there were no statistically significant differences in degree of Ⅰ muscle fatigue,level Ⅱ muscle fatigue,and muscle potential of puerperae in the three groups(P＞0.05).After treatment,the level Ⅰ or level Ⅱ muscle strength,and the degree of Ⅰ muscle fatigue or Ⅱ muscle fatigue the primary screening results of all women had no statistically significant difference (P＞0.05).Mnscle potential of women in group B and group C was higher than that of women in group A(P ＜0.05).Conclusion:The three kinds of treatment all can improve the muscle strength of puerperae with stress urinary incontinence.The average self score of women in the three groups is more than 7 points,and the degree of urine leakage of women has obviously improved comparing to before treatment.It is suggest that at least 5 times pelvic floor rehabilitation therapy can improve pelvic floor muscle strength recovery,and electrical stimulation combined with scene biofeedback training or scene biofeedback training has the best curative effect for muscle potential.