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目的:探讨盆底肌肉锻炼联合生物电刺激疗法在治疗产后压力性尿失禁的疗效,分析尿动力学的变化。方法:选取产后42天在该院做康复检查患有压力性尿失禁的患者91例,患者均接受生物电刺激和盆底肌肉锻的联合治疗,每3天1次,每次时长25~35 min,6~9周为1个疗程。治疗前后填写尿失禁生活质量问卷(I-QOL),并分析尿动力学的变化。结果:91例患者中62例(68.13%)治愈,24例(26.37%)有明显改善,5例(5.49%)无效,总有效率为94.51%。对比尿动力学各项指标的变化,患者的尿道最大闭合压力、尿道最大压力及应力性漏尿点压力等均较治疗前有明显升高(P<0.05)。结论:盆底肌肉训练联合生物电刺激的治疗方法能很好改善孕妇产后压力性尿失禁的症状,而对患者进行尿动力学分析能对其疗效做出准确客观的评价。
Objective: To investigate the efficacy of pelvic floor muscle exercise combined with bioelectrical stimulation in the treatment of postpartum stress urinary incontinence, and to analyze the changes of urodynamics. Methods: Totally 91 patients with stress urinary incontinence who underwent reexamination in the hospital 42 days postpartum were enrolled. All patients received bioelectrical stimulation combined with pelvic floor muscle forging once every 3 days for 25 ~ 35 min, 6 to 9 weeks for a course of treatment. Urine incontinence quality of life questionnaire (I-QOL) was filled before and after treatment, and urodynamic changes were analyzed. Results: Of the 91 patients, 62 (68.13%) were cured, 24 (26.37%) were significantly improved, 5 (5.49%) were ineffective and the total effective rate was 94.51%. Compared with the changes of urodynamic indexes, the maximum urethral closure pressure, the maximum urethral pressure and the stress leak pressure were significantly higher than those before treatment (P <0.05). CONCLUSION: The pelvic floor muscle training combined with bioelectrical stimulation can improve the symptoms of postpartum stress urinary incontinence in pregnant women. However, urodynamic analysis of the patients can make an accurate and objective evaluation of the curative effect.