目的 探讨呼吸训练结合盆底肌锻炼和生物反馈电刺激对产后压力性尿失禁的临床疗效。方法 2017年7月至10月,产后6周诊断为压力性尿失禁的患者64例随机分为对照组(n=32)和观察组(n=32)。对照组给予盆底肌锻炼和生物反馈电刺激治疗,观察组在对照组基础上辅以呼吸训练。治疗前和治疗12周后采用盆底肌肌电值、尿失禁次数、1 h尿垫试验和腹横肌厚度进行评价。结果 治疗前,两组盆底肌肌电值、尿失禁次数、1 h尿垫试验和腹横肌厚度均无显著性差异(P>0.05)。治疗12周后,两组盆底肌肌电值较治疗前均显著提高(t>12.564, P<0.001),且观察组显著高于对照组(t=14.064, P<0.001);两组尿失禁次数和1 h尿垫试验阳性率均显著降低(Z>9.615, P<0.001),且观察组均低于对照组(Z=-2.767, χ2=6.564, P<0.05);对照组腹横肌厚度无变化(t=-1.510, P>0.05),而观察组显著提高(t=-10.681, P<0.001),且显著高于对照组(t=7.541, P<0.001)。结论 在盆底肌锻炼和生物反馈电刺激的基础上再辅以呼吸训练,可进一步减轻产后压力性尿失禁的症状,改善功能,提高生活质量。
Objective To observe the effect of breathing training on postpartum stress urinary incontinence (SUI) based on pelvic floor muscle exercise and biofeedback electrical stimulation.Methods From July to October, 2017, 64 SUI patients at the sixth week after childbirth were randomly divided into control group (n=32) and observation group (n=32). The control group was treated with pelvic floor muscle exercise and biofeedback electrical stimulation. The observation group was supplemented with breathing training additionally. The pelvic floor muscle myoelectric value, urinary incontinence frequency, one hour urine pad test and the average thickness of the transversus abdominis were evaluated before and twelve weeks after treatment.Results Before treatment, there was no significant difference in the pelvic floor muscle myoelectric value, urinary incontinence frequency, one hour urine pad test and the average thickness of the transversus abdominis between two groups (P>0.05). Twelve weeks after treatment, the pelvic floor muscle myoelectric value significantly increased in both groups (t>12.564, P<0.001), and was higher in the observation group than in the control group (t=14.064, P<0.001); the urinary incontinence frequency and the positive rate of one hour urine pad test significantly decreased in both groups (Z>9.615, P<0.001), and were lower in the observation group than in the control group (Z=-2.767, χ2=6.564, P<0.05); the average thickness of the transversus abdominis had no improvement in the control group (t=-1.510, P>0.05), and significantly increased in the observation group (t=-10.681, P<0.01), which was higher in the observation group than in the control group (t=7.541, P<0.001).Conclusion On the basis of pelvic floor muscle exercise and biofeedback electrical stimulation, supplementation with breathing training could reduce the symptoms of postpartum stress urinary incontinence, and improve the function and the quality of life.
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