射频联合磁刺激治疗阴道松弛伴压力性尿失禁患者研究

Study on radiofrequency combined with magnetic stimulation therapy for vaginal laxity with stress urinary incontinence

摘要

目的 探讨射频联合磁刺激治疗阴道松弛(VL)伴压力性尿失禁(SUI)的临床效果,为临床治疗提供参考依据.方法 回顾性选取2024年4月至2024年10月期间在本院妇产科收治的女性压力性尿失禁伴阴道松弛患者136例作为研究对象.根据治疗方案不同分为磁刺激联合射频治疗组(即联合组)(n=69)和单纯磁刺激治疗(即对照组)(n=67).采用t检验、秩和检验及卡方检验比较两组治疗后的临床疗效以及治疗前后的1h尿垫试验漏尿量、阴道健康指数(VHIS)、盆底肌肌力、阴道松弛程度及性生活质量.结果 关于临床疗效方面,联合组总有效率为92.75%,高于对照组的74.63%,差异有统计学意义(χ²值为8.237,P<0.05).治疗后联合组VHIS评分显著高于对照组,1h尿垫试验漏尿量显著低于对照组(t值分别为7.722、6.151,均P<0.05).治疗后联合组盆底肌肌力分级4级以上者占比多于对照组,差异具有统计学意义(Z值为3.604,P<0.05).治疗后联合组中、重度阴道松弛程度占比少于对照组,差异具有统计学意义(Z值为2.853,P<0.05).治疗后联合组的女性性功能指标量表(FSFI)总分、润滑度及满意度均高于对照组,差异有统计学意义(t值分别为3.569、2.743、4.504,P<0.05).结论 射频联合磁刺激治疗阴道松弛伴压力性尿失禁具有较好的效果,可以有效提高阴道黏膜健康状态,改善漏尿情况及阴道松弛程度,促进盆底功能恢复.

Abstract

Objective To investigate the clinical efficacy of radiofrequency combined with magnetic stimulation in the treatment of vaginal laxity (VL) complicated by stress urinary incontinence (SUI), and to provide a reference for clinical treatment. Methods A total of 136 female patients with VL complicated by SUI admitted to the Department of Obstetrics and Gynecology of Qilu Hospital of Shandong University from April 2024 to October 2024 were retrospectively selected. According to different treatment protocols, the patients were divided into a combination group receiving magnetic stimulation plus radiofrequency therapy (n=69) and a control group receiving magnetic stimulation alone (n=67). The t-test, rank-sum test, and chi-square test were used to compare the clinical efficacy between the two groups after treatment, as well as the changes in 1-hour pad test leakage volume, vaginal health index score (VHIS), pelvic floor muscle strength, degree of vaginal relaxation, and sexual quality of life before and after treatment. Results The overall effective rate in the combination group was 92.75%, which was significantly higher than that in the control group (74.63%) (χ ²=8.237, P<0.05). After treatment, the VHIS score of the combination group was significantly higher, and the 1-hour pad test leakage volume was significantly lower than those of the control group (t=7.722 and 6.151, respectively, P<0.05). The proportion of patients with moderate to severe vaginal laxity was lower in the combination group (Z=2.853, P<0.05). After treatment, the total score, lubrication, and satisfaction dimensions of the female sexual function index (FSFI) were all significantly higher in the combination group than in the control group (t=3.569, 2.743 and 4.504, respectively, P<0.05). Conclusion Radiofrequency combined with magnetic stimulation therapy demonstrates a favorable therapeutic effect on patients with VL and SUI. It effectively improves vaginal mucosal health, reduces urine leakage and vaginal relaxation, and promotes recovery of pelvic floor function.

关键词

射频疗法 / 磁刺激 / 阴道松弛症 / 压力性尿失禁 / 阴道健康指数

Key words

radiofrequency therapy / magnetic stimulation / vaginal laxity / stress urinary incontinence / vaginal health index

参考文献

[1] Gonzales A L, Barnes K L, Qualls C R, et al. Prevalence and treatment of postpartum stress urinary incontinence: a systematic review [J]. Female Pelvic Med Reconstr Surg, 2021, 27(1): e139-e145.

[2] 王媛丽, 党二乐, 于磊, 等. CO₂点阵激光治疗女性阴道松弛对盆底结构及功能的影响 [J]. 中华医学美学美容杂志, 2024, 30(1): 7-12.

[3] Wang K, Xu X, Jia G, et al. Risk factors for postpartum stress urinary incontinence: a systematic review and meta-analysis[J]. Reprod Sci, 2020, 27(12): 2129-2145.

[4] 程倩, 忻悦, 周燕. 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[J]. 中国妇幼健康研究, 2025, 36(7): 91-96.

[5] 张婷婷, 张庆, 刘盼, 等. 盆底磁刺激疗法在产后盆底康复中的疗效观察[J]. 中国妇产科临床杂志, 2021, 22(5): 516-517.

[6] 中国整形美容协会女性生殖整复分会. 阴道松弛症诊断与治疗专家共识(2020年版)[J]. 中国实用妇科与产科杂志, 2020, 36(10): 965-968.

[7] 中华医学会妇产科学分会妇科盆底学组. 女性压力性尿失禁诊断和治疗指南(2017)[J]. 中华妇产科杂志, 2017, 52(5): 289-293.

[8] 韦林宜, 蒋丽. 二氧化碳点阵激光对阴道松弛患者盆底肌松弛、性生活质量及阴道黏膜相关指标的影响[J]. 中国性科学, 2020, 29(6): 83-86.

[9] 林虎梅, 陆雅君, 雅拉热措, 等. 青海省海南藏族自治州女性尿失禁情况及危险因素分析[J]. 中国妇幼健康研究, 2023, 34(9): 41-46.

[10] 曾小玲, 李旭红, 周艳华, 等. 二氧化碳激光联合肌电生物反馈疗法治疗阴道松弛的疗效观察[J]. 中华物理医学与康复杂志, 2021, 43(1): 73-75.

[11] 王庆, 袁文凤, 李俊强, 等. 微点阵激光联合雌三醇乳膏治疗绝经后压力性尿失禁[J]. 中国临床研究, 2023, 36(5): 693-697.

[12] 李嫜洁, 张莉娟, 朱燕华, 等. 盆底磁刺激联合盆底肌训练对女性膀胱过度活跃症的疗效观察[J]. 中国康复医学杂志, 2023, 38(1): 101-104.

[13] He Q, Xiao K, Peng L, et al. An effective meta-analysis of magnetic stimulation therapy for urinary incontinence[J]. Sci Rep, 2019, 9(1): 9077.

[14] 何雨欣, 杨闪闪, 江美, 等. 磁刺激联合生物反馈技术在压力性尿失禁中的临床应用价值[J]. 实用妇产科杂志, 2024, 40(9): 762-765.

[15] 宋文静, 王晶, 刘美华, 等. 温控射频治疗盆底功能障碍性疾病的研究进展[J]. 国际妇产科学杂志, 2023, 50(2): 176-180.

[16] 高竹薇, 陈星慧, 何军晶, 等. 妇科射频联合生物反馈电刺激治疗子宫脱垂疗效分析[J]. 昆明医科大学学报, 2022, 43(6): 127-131.

[17] Allan B B, Bell S, Husarek K. A 12-month feasibility study to investigate the effectiveness of cryogen-cooled monopolar radiofrequency treatment for female stress urinary incontinence[J]. Can Urol Assoc J, 2020, 14(7): E313-E318.

[18] 张冉, 张明, 刘风平, 等. 磁电联合综合盆底康复治疗对盆底松弛患者的疗效观察[J]. 中华临床医师杂志(电子版), 2021, 15(9): 646-651.

[19] 童瑶, 李旭红, 严文广, 等. 射频联合磁刺激治疗对轻中度盆腔器官脱垂的疗效[J]. 中南大学学报(医学版), 2023, 48(11): 1696-1702.

[20] Kolczewski P, Parafiniuk M, Zawodny P, et al. Hyaluronic acid and radiofrequency in patients with urogenital atrophy and vaginal laxity [J]. Pharmaceuticals (Basel), 2022, 15(12): 1571.