【摘要】：目的探討產(chǎn)后女性壓力性尿失禁病人生物反饋治療果效及盆底肌表面電信號變化的臨床意義。方法選擇62例產(chǎn)后輕度壓力性尿失禁病人進入前瞻性研究;應(yīng)用SOKO9003型治療儀進行生物反饋治療,對自然分娩和選擇性剖宮產(chǎn)組治療前后盆底肌表面肌電信號包括盆底肌Ⅰ、Ⅱ類纖維的活力值及肌力進行檢測,對肌力牛津改良量表(Modified Oxford Scale,MOS)評分進行主觀評估。隨訪6個月再次評價上述指標,觀察盆底肌表面電信號變化及治療效果。結(jié)果治療5周后,62例中54例治療有效,總有效率為87.1%(54/62),其中陰道分娩組治療有效率為96.9%(31/32),剖宮產(chǎn)組治療有效率76.7%(23/30),陰道分娩組治療有效率較剖宮產(chǎn)組高,2組差異有統(tǒng)計學意義(P=0.024);隨訪6個月后,62例中48例治療有效,總有效率為77.4%(48/62),陰道分娩組治療有效率87.5(28/32),剖宮產(chǎn)組治療有效率66.7(20/30),陰道分娩組治療有效率仍高于剖宮產(chǎn)組,2組差異有統(tǒng)計學意義(P=0.050)。短期治療后,陰道分娩組肌力的MOS評分差值與剖宮產(chǎn)組MOS評分差值相比較,陰道分娩組MOS評分差高于剖宮產(chǎn)組(P=0.040);長期治療后,陰道分娩組肌力的MOS評分差值與剖宮產(chǎn)組MOS評分差值相比較,陰道分娩組MOS評分差仍高于剖宮產(chǎn)組(P=0.030)。長期治療與短期治療后陰道分娩組的盆底肌Ⅰ、Ⅱ類肌纖維活力的改變量均大于剖宮產(chǎn)組(P0.05),但是治療時限對盆底肌Ⅰ、Ⅱ類肌纖維活力的改變量差異無統(tǒng)計學意義(P0.05);治療時限對MOS評分差異無統(tǒng)計學意義(P0.05)。結(jié)論盆底肌生物反饋療法能夠有效治療產(chǎn)后女性壓力性尿失禁(stress urinary incontinence,SUI)。治療后陰道自然分娩(vaginal delivery,VD)產(chǎn)婦盆底肌功能恢復(fù)快,盆底康復(fù)治療療效明顯優(yōu)于擇期剖腹產(chǎn)(caesarean section,CS)者,分娩對盆底組織的損傷是可恢復(fù)的。
[Abstract]:Objective to investigate the clinical significance of biofeedback in the treatment of postpartum female stress urinary incontinence and the changes of surface electrical signal of pelvic floor muscle. Methods 62 patients with postpartum mild stress urinary incontinence were enrolled in a prospective study. Biofeedback therapy was performed with SOKO9003 therapeutic instrument. The surface EMG signals of pelvic floor muscle, including the activity value and muscle strength of pelvic floor muscle type I and II fibers, were measured before and after treatment in natural delivery and selective cesarean section group, and the score of Oxford modified scale (Modified Oxford Scale,MOS) was evaluated subjectively. The above indexes were evaluated again after 6 months follow-up, and the changes of surface electrical signal of pelvic floor muscle and its therapeutic effect were observed. Results after 5 weeks of treatment, 54 of 62 cases were effective, the total effective rate was 87.1% (54 鈮，

本文編號：2505704