核心肌群训练联合盆底肌电刺激与生物反馈治疗对产后压力性尿失禁患者盆底功能的影响

Effect of core muscle training combined with pelvic floor electrical stimulation and biofeedback therapy on pelvic floor function in postpartum patients with stress urinary incontinence

摘要

目的 探究核心肌群训练联合盆底肌电刺激、生物反馈治疗对产后压力性尿失禁(SUI)患者盆底功能恢复的疗效。方法 选取2020年1月至2023年12月收治的产后SUI产妇为研究对象,经随机数字表法分为观察组和对照组,每组184例,对照组进行盆底肌电刺激、生物反馈治疗,观察组在对照组基础上联合核心肌群训练.记录治疗5周后的临床疗效;比较两组盆底功能[Ⅰ类肌纤维肌力、Ⅱ类肌纤维肌力、盆底功能障碍问卷(PFDI-20)评分]、尿失禁情况[1h失禁量、平均24h漏尿频次、国际尿失禁问卷-尿失禁简表(ICIQ-UISF)评分]、尿动力学(平均尿流率、最大膀胱容量、残余尿量)、生活质量(I-QOL评分)差异。结果 治疗5周后,观察组临床疗效显著高于对照组(χ²=7.763,P<0.05);两组产妇Ⅰ类肌纤维肌力(t值分别为62.010、57.192,P<0.05)、Ⅱ类肌纤维肌力(t值分别为74.236、67.025,P<0.05)、平均尿流率(t值分别为27.777、17.469,P<0.05)、最大膀胱容量(t值分别为17.797、13.414,P<0.05)、I-QOL评分(t值分别为18.631、9.928,P<0.05)均显著升高,且观察组高于对照组(t值分别为6.453、5.500、7.328、4.075、4.595,P<0.05),两组产妇PFDI-20评分(t值分别为89.387、64.448,P<0.05)、1h尿失禁量(t值分别为116.322、58.685,P<0.05)、平均24h漏尿频次(t值分别为87.447、58.556,P<0.05)、ICIQ-UISF评分(t值分别为69.656、51.971,P<0.05)、残余尿量(t值分别为32.138、27.206,P<0.05)均降低,且观察组低于对照组(t值分别为24.533、35.925、46.818、19.120、11.207,P<0.05)。结论 核心肌群训练联合生物反馈电刺激在产后SUI中临床效果明显,能够恢复产妇盆底功能,改善尿失禁情况和产妇的生活质量.

Abstract

Objective To investigate the efficacy of core muscle group training combined with pelvic floor electrical stimulation and biofeedback therapy on pelvic floor function recovery in postpartum women with stress urinary incontinence (SUI). Methods Postpartum women with SUI admitted between January 2020 and December 2023 were selected as study subjects. They were randomly divided into an observation group and a control group, with 184 cases in each group. The control group received pelvic floor electrical stimulation and biofeedback therapy, while the observation group received additional core muscle group training based on the control group's treatment. Clinical efficacy was assessed after five weeks of treatment. The two groups were compared in terms of pelvic floor function [type Ⅰ muscle fiber strength, type Ⅱ muscle fiber strength, and Pelvic Floor Distress Inventory-20 (PFDI-20) score], urinary incontinence status [1-hour urine leakage volume, mean 24-hour urinary leakage frequency, and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF) score], urodynamic parameters (mean urine flow rate, maximum bladder capacity, and post-void residual volume), and quality of life [Incontinence Quality of Life Questionnaire (I-QOL)]. Results After five weeks of treatment, the clinical efficacy in the observation group was significantly higher than in the control group (χ²=7.763, P<0.05). In both groups, type Ⅰ muscle fiber strength (t=62.010 and 57.192, respectively, P<0.05), type Ⅱ muscle fiber strength (t=74.236 and 67.025, respectively, P<0.05), mean urine flow rate (t=27.777 and 17.469, respectively, P<0.05), maximum bladder capacity (t=17.797 and 13.414, respectively, P<0.05), and I-QOL score (t=18.631 and 9.928, respectively, P<0.05) significantly increased, with the observation group showing greater improvement than the control group (t=6.453, 5.500, 7.328, 4.075 and 4.595, respectively, P<0.05). Conversely, PFDI-20 score (t=89.387 and 64.448, respectively, P<0.05), 1-hour urine leakage volume (t=116.322 and 58.685, respectively, P<0.05), mean 24-hour urinary leakage frequency (t=87.447 and 58.556, respectively, P<0.05), ICIQ-UISF score (t=69.656 and 51.971, respectively, P<0.05), and post-void residual volume (t=32.138 and 27.206, respectively, P<0.05) all decreased, with the observation group showing more significant reductions than the control group (t=24.533, 35.925, 46.818, 19.120 and 11.207, respectively, P<0.05). Conclusion Core muscle group training combined with biofeedback electrical stimulation has a significant clinical effect in postpartum SUI. It can effectively restore pelvic floor function, improve urinary incontinence symptoms, and enhance the quality of life of postpartum women.

关键词

产后压力性尿失禁 / 核心肌群训练 / 盆底肌电刺激 / 生物反馈 / 盆底功能

Key words

postpartum stress urinary incontinence / core muscle group training / pelvic floor electrical stimulation / biofeedback / pelvic floor function

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