摘要
目的探讨产后盆底肌训练(PFMT)联合低频电刺激与生物反馈干预对产后压力性尿失禁(PSUI)患者的临床疗效。方法60例PSUI患者,采用随机数字表法分为实验组与对照组,各30例。实际完成干预并完成随访评估患者57例,其中实验组29例,对照组28例。对照组接受常规产后康复指导及PFMT,实验组在对照组基础上联合低频电刺激与生物反馈干预。比较两组患者干预前后盆底肌功能客观指标[盆底肌表面肌电(sEMG)、耻骨直肠肌厚度、提肛肌裂孔面积]、尿失禁相关指标[国际尿失禁咨询委员会尿失禁问卷表简表(ICIQ-SF)评分、1 h漏尿量、日均漏尿次数]及生活质量[尿失禁生活质量问卷(I-QOL)评分],临床疗效。结果干预6、12周后,两组盆底肌sEMG最大收缩值、耻骨直肠肌厚度较本组干预前明显升高,提肛肌裂孔面积较本组干预前明显减小,且实验组盆底肌sEMG最大收缩值(28.24±5.33)、(35.48±5.60)μV和耻骨直肠肌厚度(7.85±0.81)、(8.54±0.81)mm高于对照组的(24.15±5.10)、(27.98±5.25)μV和(7.32±0.77)、(7.64±0.75)mm,提肛肌裂孔面积(11.24±1.74)、(9.98±1.50)cm^(2)小于对照组的(12.20±1.80)、(11.48±1.66)cm^(2)(P<0.05)。干预6、12周后,两组ICIQ-SF评分、1 h漏尿量、日均漏尿次数均较本组干预前明显下降,I-QOL评分较本组干预前明显上升,且实验组ICIQ-SF评分、1 h漏尿量、日均漏尿次数低于对照组,I-QOL评分高于对照组(P<0.05)。实验组总有效率为93.10%,高于对照组的64.29%(P<0.05)。结论产后PFMT联合低频电刺激与生物反馈干预可有效改善PSUI患者产后尿失禁症状,增强盆底功能,提升生活质量,临床疗效优于单纯PFMT,值得在产后康复中推广应用。
Objective To evaluate the clinical efficacy of pelvic floor muscle training(PFMT)combined with low-frequency electrical stimulation and biofeedback in the treatment of postpartum stress urinary incontinence(PSUI).Methods 60 women with PSUI were divided into the experimental group(n=30)and the control group(n=30)according random numerical table.A total of 57 patients completed the intervention and follow-up assessment,including 29 cases in the experimental group and 28 cases in the control group.The control group received conventional postpartum rehabilitation guidance and PFMT.The experimental group underwent additional low-frequency electrical stimulation and biofeedback therapy based on the control group.Comparison of objective indicators of pelvic floor muscle function[surface electromyography(sEMG),puborectalis muscle thickness,levator ani hiatus area],urinary incontinence-related indicators[International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF)score,1-h urine leakage volume,average daily incontinence frequency],and quality of life[Incontinence Quality of Life(I-QOL)score]before and after intervention before and after the intervention,and clinical efficacy between two patient groups.Results After 6 and 12 weeks of intervention,both groups showed significantly increased maximum contraction values of sEMG and puborectalis muscle thickness compared to pre-intervention levels in their respective groups,and the levator ani hiatus area was significantly reduced compared to pre-intervention levels in their respective groups.Furthermore,the maximum contraction values of sEMG in the experimental group were(28.24±5.33)and(35.48±5.60)μV,and the puborectalis muscle thickness were(7.85±0.81)and(8.54±0.81)mm,which were higher than those in the control group[(24.15±5.10),(27.98±5.25)μV and(7.32±0.77),(7.64±0.75)mm];the levator ani hiatus area were(11.24±1.74)and(9.98±1.50)cm2,which were smaller than those in the control group[(12.20±1.80)and(11.48±1.66)cm2](P<0.05).After 6 and 12 weeks of intervention,both groups showed significant reductions in ICIQ-SF scores,1-h urine leakage volume,and average daily incontinence frequency compared to pre-intervention levels,and I-QOL scores significantly increased compared to pre-intervention levels.Moreover,the experimental group exhibited lower ICIQ-SF scores,1-h urine leakage volume and average daily incontinence frequency compared to the control group,while demonstrating higher I-QOL scores(P<0.05).The total effective rate in the experimental group was significantly higher than the control group's(93.10%vs.64.29%,P<0.05).Conclusion PFMT combined with low-frequency electrical stimulation and biofeedback effectively improves postpartum urinary incontinence symptoms in patients with PSUI,enhances pelvic floor function,and improves patients'quality of life.This combined approach is more effective than PFMT alone,and is recommended for clinical implementation in postpartum rehabilitation.
作者
贺昔春
严玲
张慧珍
HE Xi-chun;YAN Ling;ZHANG Hui-zhen(Department of Obstetrics and Gynecology,Jiujiang First People's Hospital,Jiujiang 332000,China)
出处
《中国实用医药》
2026年第5期167-171,共5页
China Practical Medicine
关键词
产后压力性尿失禁
盆底肌训练
生物反馈
低频电刺激
生活质量
Postpartum stress urinary incontinence
Pelvic floor muscle training
Biofeedback
Low-frequency electrical stimulation
Quality of life
