健脾益肾方、生物反馈联合盆底肌功能训练治疗老年女性压力性尿失禁的效果观察

目的：观察健脾益肾方、生物反馈联合盆底肌功能训练治疗老年女性压力性尿失禁的效果。方法：将126例老年女性压力性尿失禁患者随机分为对照组和观察组,每组各63例。对照组给予盆底肌功能训练,观察组在对照组的基础上给予健脾益肾方联合盆底生物反馈内外合治,对比两组的尿流动力学相关参数、1 h尿失禁、24 h尿失禁次数、国际尿失禁咨询问卷简表（ICI-Q-SF）评分、盆底肌电位值、尿失禁生活质量量表(I-QOL)评分,监测血清中转化生长因子-β1(TGF-β1)、25羟维生素D(25-OHD)含量。结果：观察组患者的有效率显著高于对照组（P<0.05）;与对照组比较,观察组治疗后的尿流动力学相关参数ALPP、MUCP、BC、QMax、PMU、VMCC均显著升高（P<0.05）;1 h尿失禁量显著减少,24 h尿失禁次数显著下降（P<0.05）;治疗4周、8周后,观察组患者的ICI-Q-SF评分均显著低于对照组(P<0.05);观察组治疗后的盆底肌电位值（65.32±7.19）μV显著高于对照组的（54.25±5.36）μV(P<0.05);治疗4周、8周后,观察组患者...     

生物反馈盆底肌肉训练治疗男性获得性尿失禁的体会

目的 探讨生物反馈盆底肌肉训练治疗男性获得性尿失禁效果.方法 61例尿失禁的患者,按照各人意愿将其分为对照组(30例)和实验组(31例).对照组行单纯盆底肌肉训练,实验组接受生物反馈盆底肌肉训练.治疗前后分别计量患者每日自觉尿失禁次数、24h尿垫重量、膀胱残余尿、盆底肌表面肌电信号值.结果 治疗前各项指标差异无统计学意义(P＞0.05).治疗后,实验组与对照组比较,盆腔外伤术后以及神经源性尿失禁次数差异无统计学意义(P＞0.05).余统计量均有差异(P＜0.05).实验组治疗前后比较,神经源性的盆底肌表面肌电信号值为0.076,无差异,余统计量均有差异(P＜0.05).对照组治疗前后比较,神经源性的尿失禁次数以及膀胱残余尿量P分别为0.09、0.05,差异无统计学意义,余统计量均有差异(P＜0.05).结论 生物反馈系统盆底肌肉训练治疗男性获得性尿失禁是一种有效的、治愈率较高的治疗手段.     

盆底肌训练联合电刺激生物反馈用于原位新膀胱术后患者尿失禁干预

目的 探究盆底肌训练联合电刺激生物反馈用于原位新膀胱术后患者尿失禁的效果。 方法 将97例膀胱癌行原位新膀胱术患者按时间段分为对照组46例、观察组51例；对照组实施术后常规盆底肌训练；观察组在对照组基础上增加盆底电刺激联合生物反馈干预。干预2个疗程后评价效果。 结果 观察组尿失禁干预有效率、膀胱容量、尿流率、膀胱逼尿肌压力、排尿间隔时间及平均每次尿量均显著优于对照组（均P＜0.05）。 结论 盆底肌训练联合电刺激生物反馈可有效改善膀胱癌原位新膀胱术后患者尿失禁，提高尿控能力。     

生物反馈联合盆底肌训练治疗女性压力性尿失禁的疗效

目的:探讨生物反馈联合盆底肌训练治疗女性压力性尿失禁(Stress urinary incontinence,SUI)的临床效果.方法:2005年11月～2007年3月,对11例女性SUI患者使用生物反馈治疗仪进行生物反馈电刺激联合盆底肌训练治疗.治疗前通过病史、体检、尿动力学检查诊断为尿失禁.治疗每次20 min,每天1次,5次为1个疗程.结果:11例女性SUI患者中,7例症状消失,4例症状减轻.追踪观察6个月,无一例复发.结论:生物反馈联合盆底肌训练是一种安全、有效的治疗女性SUI的方法.     

生物反馈盆底电刺激联合盆底肌训练治疗产后压力性尿失禁效果观察

目的探讨神经肌肉电刺激联合盆底肌训练治疗产后压力性尿失禁的效果。方法将本院2016-01—2017-12间收治的60例产后压力性尿失禁的初产妇分为2组,各30例。对照组采用盆底肌训练,观察组采用盆底肌训练联合神经肌肉电刺激治疗。观察2组的治疗效果及治疗后6个月盆底肌力的改善程度。结果 2组治疗期间均未发生不良反应。观察组治疗总有效率高于对照组,差异有统计学意义(P0.05)。治疗6个月后2组盆底肌收缩力评分均较治疗前明显改善,观察组改善程度高于对照组,差异有统计学意义(P0.05)。结论对产后压力性尿失禁患者实施神经肌肉电刺激联合盆底肌训练,可有效改善盆底肌力和尿失禁,且无不良反应,安全性高。     

点阵CO2激光治疗女性轻中度压力性尿失禁的临床疗效分析

目的探究经阴道点阵CO₂激光治疗女性轻、中度压力性尿失禁(SUI)的临床疗效。方法回顾性研究本院2017年1月至2020年12月收治的轻中度SUI女性患者。激光治疗组41例,进行点阵CO₂激光联合盆底肌训练治疗,每月治疗1次,共治疗3次;生物反馈治疗组20例,采用生物反馈电刺激联合盆底肌训练。比较两组患者治疗后临床疗效、国际尿失禁委员会尿失禁问卷简表(ICI-Q-SF)、尿失禁生活质量问卷(I-QOL)及女性性功能量表(FSFI)评分。结果治疗后,激光治疗组总有效率为92.68%,疗效强于生物反馈组(P<0.05);治疗后ICI-Q-SF、I-QOL、FSFI评分均得到改善(P<0.01);与生物反馈治疗组比较,激光治疗组I-QOL、FSFI增加更显著(P<0.05),ICI-Q-SF评分明显降低(P<0.01)。3例患者治疗时述阴道烧灼感,休息后好转,5例患者出现一过性的尿急,部分患者阴道分泌物增多后自行恢复,整个治疗过程无其他不良事件发生。结论点阵CO₂激光治疗能够有效改善轻、中度SUI患者的...     

女性压力性尿失禁术后患者行盆底肌肉锻炼的控尿效果观察

目的探讨女性压力性尿失禁术后患者行盆底肌肉锻炼的效果。方法回顾性分析医院100例轻、中度压力性尿失禁患者临床治疗情况,其中以常规药物治疗者为对照组,50例;行盆底肌肉锻炼者为观察组,50例。评价两组治疗前后排尿状况和盆底肌力评分,记录两组控尿效果(漏尿量、漏尿程度、漏尿次数)。根据患者治疗状况以问卷形式调查患者治疗效果。结果两组患者治疗后排尿状况评分较治疗前显著下降,观察组下降更显著,而盆底肌力评分明显升高,观察组升高程度显著,P0.05。观察组漏尿次数、漏尿量,明显少于对照组,且漏尿程度低于对照组,P0.05。观察组患者主观疗效明显优于对照组,P0.05。结论女性压力性尿失禁患者术后行盆底肌肉锻炼可通过提高患者盆底肌力来起到较好的控尿效果,值得推荐。     

生物反馈联合电刺激治疗中老年女性压力性尿失禁的疗效观察

目的评价生物反馈联合电刺激治疗中老年女性压力性尿失禁的效果。方法采用便利抽样法选取2015年9月1日到2017年12月31日在复旦大学附属上海市第五人民医院就诊的168例中老年女性压力性尿失禁患者分成两组。观察组84例给予生物反馈联合电刺激锻炼盆底肌,每周2次,每次30min;对照组84例给予单纯Kegel锻炼盆底肌。比较两组患者治疗前及治疗后4周、8周的排尿相关指标:3d漏尿次数、1h尿垫试验漏尿量、尿失禁问卷简表(ICI-Q-SF)、盆底肌肉功能Glazer评估测试,评价两种方法对于盆底肌肉功能训练的效果。结果观察组治疗后4周及8周的排尿相关指标同对照组相比,尿失禁问卷简表(ICI-Q-SF)得分(5.8±2.4 vs.7.9±2.7,P0.01;7.2±2.9 vs.8.9±3.1,P0.01)、1h尿垫试验漏尿量[(4.87±1.92)g vs.(7.79±2.08)g,P0.05;(6.42±0.86)g vs.(9.43±0.94)g,P0.05)]和3d漏尿次数[(2.48±2.35)次vs.(4.86±2.17)次,P0.05;(3.15±1.26)次vs.(5.55±1.63)次,P0.05]等结果均优于对照组,差异有统计学意义。结论盆底生物反馈联合电刺激治疗中老年女性压力性尿失禁优于单纯Kegel锻炼方法,值得临床推广。     

生物反馈联合电刺激治疗中年女性压力性尿失禁的疗效观察

目的探讨电刺激联合生物反馈盆底肌锻炼治疗女性压力性尿失禁的效果。方法回顾性分析2018年2月至2018年12月在本院就诊的120名压力性尿失禁患者的临床资料,分为观察组(72例)和对照组(48例)。观察组采用多媒体生物刺激反馈治疗,同时自行盆底肌肉训练(Kegel),对照组自行做Kegel锻炼盆底肌肉。随访观察治疗效果,对患者进行疗效评判和主观评分。结果治疗后观察组总漏尿事件次数(LT)、PISQ-12评分、ICI-Q-SF评分明显下降,差异有统计学意义(P0.05);治疗后观察组功能性膀胱容量(VF)较对照组有显著上升,差异有统计学意义(P0.05)。治疗后疗效观察组较对照组都有了明显的改善。结论盆底生物反馈联合电刺激治疗女性压力性尿失禁的疗效优于单纯的锻炼盆底肌肉,并且安全有效、治愈率高,是一种治愈率较高的方法,值得临床实践和推广。     

不同分娩方式对产后早期盆底肌力影响及电刺激联合生物反馈等盆底肌康复治疗体会

目的分析顺产与剖宫产分娩方式对初产妇产后近期盆底肌力的影响及电刺激联合生物反馈等盆底肌康复治疗的效果。方法选取2017-12—2018-06间在黄河中心医院分娩的80例初产妇。根据分娩方式分为顺产组和剖宫产组,每组40例。产后6周应用PHENIX USB2检测仪量化评估盆底肌力后,对初筛结果盆底肌力下降(≤Ⅲ级)的初产妇均采用电刺激联合生物反馈等盆底肌康复治疗后再次检测产妇盆底肌力。结果剖宫产组产后42 d后盆底肌力下降率低于顺产组,差异有统计学意义(P0.05)。剖宫产组中肌力下降的初产妇治疗后有效率(盆底肌力Ⅲ级)高于顺产组,但差异无统计学意义(P0.05)。结论剖宫产初产妇产后盆底肌力下降率低于顺产产妇,但不能成为避免盆底肌肉受损程度而选择分娩方式的依据。无论何种分娩方式,术后出现盆底肌力受损的初产妇通过电刺激联合生物反馈治疗,可有效改善盆底功能障碍。     

The effect of postpartum pelvic floor muscle exercise in the prevention and treatment of urinary incontinence

The aim of this study was to evaluate the effect of postpartum pelvic floor muscle exercise in the prevention and treatment of urinary incontinence. A prospective comparison design of 99 matched pairs (n=198) of mothers, a training group and a control group, was used. Eight weeks postpartum the training group attended an 8-week intensive pelvic floor muscle exercise course, training in groups led by a physical therapist for 45 minutes once a week. In addition they were asked to exercise at home at least three times per week. The control group followed the ordinary written postpartum instructions from the hospital. Pelvic floor muscle strength was measured pretreatment at the eighth, and post-treatment at the 16th week after delivery, using a vaginal balloon catheter connected to a pressure transducer. Vaginal palpation and observation of inward movement of the balloon catheter during contraction were used to test the ability to perform correct the pelvic floor muscle contraction. Urinary leakage was registered by interview, specially designed instruments to measure how women perceive SUI, and a standardized pad test. At baseline (8 weeks postpartum) there was no significant difference in the number of women with urinary incontinence in the training group compared to the control group. At 16 weeks postpartum, after the 8-week treatment period, there was a significant (P<0.01) difference in favor of the training group. In addition, a significantly greater improvement in pelvic floor muscle strength between test 1 and test 2 was found in the training group compared to the control group. The results show that a specially designed postpartum pelvic floor muscle exercise course is effective in increasing pelvic floor muscle strength and reducing urinary incontinence in the immediate postpartum period. EDITORIAL COMMENT: This paper is one of only a few looking at the efficacy of a rigorous pelvic floor muscle exercise training regime to help women with incontinence in the postpartum period. Whether or not these results will translate long-term into a lower incidence of urinary incontinence as these women age, is unknown, and may never be known. However, this paper points out that there is a definite benefit from pelvic floor muscle exercise for the treatment of postpartum incontinence, and we can use this information to more strongly counsel our patients in the use of these exercises.     

Effects of pelvic floor muscle training on strength and predictors of response in the treatment of urinary incontinence

AIMS: The objectives of this study were (1) to determine the effect of training on pelvic floor muscle strength; (2) to determine whether changes in pelvic floor muscle strength correlate with changes in continence; and (3) to determine whether demographic characteristics, clinical incontinence severity indices, or urodynamic measures predict response to pelvic floor muscle training. METHODS: One hundred thirty-four women with urinary incontinence (95=genuine stress incontinence [GSI]; 19=detrusor instability [DI]; 20=mixed incontinence [GSI+DI]) were randomized to pelvic floor muscle training (n=67) or bladder training (n=67). Urinary diaries, urodynamic evaluation, and vaginal pressure measurements by using balloon manometry were performed at baseline and after 12 weeks of therapy. Primary outcome measures consisted of incontinent episodes per week and vaginal pressure measurements. RESULTS: Both treatment groups had a reduction in incontinent episodes (P相似文献   

The effect of training with vaginal weighted cones and pelvic floor exercises on the strength of the pelvic floor muscles: A pilot study

A pretest-post-test design (n=14) was used to investigate pelvic floor muscle (PFM) strength over a 2-month training period using vaginal cones with pelvic floor exercises in the treatment of female stress incontinence, and to correlate any changes in muscle strength with objective and subjective measures of stress incontinence. PFM strength was assessed by vaginal examination and the ability to retain the cones. The symptom of stress incontinence was assessed using rating scales, and measured objectively by the extended pad test. The results showed a significant increase in muscle strength (P<0.05). An unexpected finding was that most of the improvement in PFM function occurred in a 1-week baseline assessment period before training was commenced. It is therefore suggested that the increase in force generation occurred due to a process of neural adaptation rather than muscle hypertrophy. No significant correlations were found between muscle strength and objective or subjective measures of stress incontinence.Editorial Comment: Vaginal cones are gaining in popularity as a method of therapy for stress incontinence. As in this study, the symptom of stress incontinence was enough to begin treatment and objective documentation of the diagnosis was not undertaken. The therapy has no side-effects and only requires that the patient is motivated enough to put the cone in the vagina and take it out after a prescribed time period. Everything else is automatic. Biofeedback from the perception of the cone falling out provides the stimulus for pelvic floor contraction. Success rates are high, with 21% cured and 29% improved for an overall improvement rate of 50%. Such therapies may be tried before diagnosis, and certainly before expensive surgical treatment.     

盆底肌锻炼在女性压力性尿失禁患者中的应用价值

目的：探讨盆底肌锻炼在女性压力性尿失禁患者中的应用价值。方法选择2011年3月-2013年3月我院接诊的80例女性压力性尿失禁患者进行研究。按照随机数字表法,随机分为观察组和对照组。对照组采用常规的体操锻炼对患者进行治疗,观察组采用新式的盆底肌锻炼对患者进行治疗。观察记录两组患者治疗前后的肌力状况,治疗前后漏尿量及尿垫试验的结果,并采用治疗后的临床疗效评价标准对两组患者治疗临床疗效进行比较分析。结果两组患者治疗后肌力均明显增高（P＜0.01）,治疗后观察组肌力明显高于对照组（P＜0.01）;治疗后,观察组患者的肌力分度明显优于对照组,两组比较差异有统计学意义（u=-2.4795,P=0.0132）。观察组患者的漏尿量明显少于对照组（P＜0.01）,治疗后3、6及12个月后,患者尿垫试验阳性率明显低于对照组（P＜0.05）。治疗总有效率（97.5%）明显高于对照组（72.5%）,两组比较差异有统计学意义（u=-2.9441,P=0.0032）。结论盆底肌锻炼在女性压力性尿失禁患者中的应用价值较高,值得临床推广应用。     

负压治疗联合盆底肌训练对前列腺癌根治术后患者控尿功能及性功能的影响

目的探讨负压治疗联合盆底肌训练对前列腺癌根治术后患者控尿功能及主观幸福感的影响。方法将中山大学附属第三医院2016年10月至2019年4月泌尿外科确诊为前列腺癌并行腹腔镜下前列腺癌根治术治疗的70例患者,按随机数字表法分为干预组和对照组各35例,其中对照组35例采用常规护理(盆底肌功能锻炼),干预组35例在常规护理基础上,术后6周起再增加负压治疗。比较对照组和干预组术后6周、10周、18周控尿功能恢复情况,同时进行国际勃起功能评分表(IIEF-5)评分及主观幸福感调查,观察其治疗效果。结果干预组术后6周、10周、18周尿失禁评分中位值分别2分、1分与0分,低于对照组的2分、2分与2分,提示干预组术后平均控尿功能恢复时间较对照组短,差异有统计学意义(P<0.05);此外干预组相比对照组,IIEF-5评分及主观幸福感评分上升速度较快,提示干预组术后勃起功能和生活质量改善情况明显优于对照组。结论负压治疗联合盆底肌训练对前列腺癌根治术后患者的控尿功能和性功能有明显改善,且缩短其恢复时间。     

Cues to action: Pelvic floor muscle exercise compliance in women with stress urinary incontinence

Pelvic floor muscle exercises are recommended as an initial treatment to women with stress urinary incontinence. This treatment is often unsuccessful because of patient noncompliance. A post-test, experimental control group design was used to examine Pender's (1992) concept of an external cue to action, an audiocassette tape, to enhance patient compliance to pelvic floor exercises. Eighty-six women with urodynamically evaluated stress urinary incontinence participated through a Pelvic Floor Exercise Unit at a large teaching hospital. Patients received biofeedback training and written information to reinforce pelvic floor muscle exercises during a 45-min appointment with a nurse. Patients were instructed to perform the exercises for 10 min twice daily. Forty-three woman randomly assigned to an experimental group received an audiocassette tape. Four to 6 weeks later all patients completed a researcher-developed questionnare that was validity and reliability tested assessing pelvic floor exercise compliance. The 43 patients (100%) who received the audiocassette tape reported compliance with “routine” exercises. Twenty-two of 34 patients (65%) who did not receive the tape were compliant (P = 0.0003). Thirty-four of 41 patients (83%) who received the tape reported exercise compliance twice a day, while 4 of 34 patients (12%) in the control group were similarly compliant (P = 0.0000). The findings suggest adding an audiocassette tape to a pelvic floor exercise program enhances patient compliance for incontinent women compared to verbal and written instruction combined with biofeedback. Neurourol. Urodynam. 16:167–177, 1997. © 1997 Wiley-Liss, Inc.     

Biofeedback or pelvic floor muscle exercises for female genuine stress incontinence: a meta-analysis of trials identified in a systematic review.

OBJECTIVE: To test, by meta-analysis, the conclusion of a systematic review that biofeedback was no more effective than pelvic floor muscle exercises alone for the treatment of female genuine stress urinary incontinence. MATERIALS AND METHODS: Data extracted from the five trials identified in the systematic review were subjected to pooled analysis of odds ratios for the outcome of 'cure'. RESULTS: The odds ratio for biofeedback combined with pelvic floor muscle exercises, compared with pelvic floor muscle exercises alone, leading to cure was 2.1 (95% confidence interval 0.99-4.4). CONCLUSIONS: Biofeedback may be an important adjunct to pelvic floor muscle exercises alone in the treatment of female genuine stress urinary incontinence. A quantitative statistical analysis of the studies identified leads to different conclusions from those in the systematic review.     

Pelvic floor muscle strength and response to pelvic floor muscle training for stress urinary incontinence

AIMS: Several randomized controlled trials have demonstrated that pelvic floor muscle training is effective to treat stress urinary incontinence. The aim of the present study was to compare muscle strength increase and maximal strength in responders and non-responders to pelvic floor muscle training. MATERIALS AND METHODS: Fifty-two women with urodynamically proven stress incontinence who had participated in a six months randomized controlled trial on pelvic floor muscle training, mean age 45.4 years (range 24-64), participated in the study. The women were classified as responders and non-responders based on a combination of five effect variables covering urodynamic measurement, pad test with standardized bladder volume, and self-reports. Pelvic floor muscle strength was measured with a vaginal balloon connected to a fiber optic micro tip transducer (Camtech AS, Sandvika, Norway). RESULTS: There was a positive correlation between improvement in PFM maximal strength and improvement measured by leakage index (r = 0.34, P < 0.01), and reduction in urinary leakage measured by the pad test (r = 0.23, P = 0.05). The total sample of 52 women comprised 21 responders, 18 unclassifiable, and 13 non-responders. There was a statistically significant difference in maximal strength after the training period between responders and non-responders; 24.0 cm H2O (95% CI:18.1-29.9) versus 12.7 cm H2O (95% CI: 6.8-18.6) P < 0.001), and strength increase; 14.8 cm H2O (95% CI: 8.9-20.7) versus 5.0 cm H2O (95% CI: 2.6-12.6), respectively (P = 0.03). CONCLUSIONS: There was a positive relation between both pelvic floor muscle strength increase and maximal strength, and improvement of stress urinary incontinence.     

生物反馈电刺激联合药物在绝经后盆腔器官脱垂盆底重建术后应用

目的探究生物反馈电刺激技术联合雌二醇凝胶用于绝经后盆腔器官脱垂（POP）患者盆底重建术后的疗效及其对并发症的影响。 方法选取2019年10月至2021年10月秦皇岛市第一医院妇科病区及妇科门诊收治的绝经后POP行盆底重建术的患者222例为研究对象,将符合入组标准的患者按随机数字表法分成3组：生物反馈电刺激组（A组）、药物疗法组（B组）、生物反馈电刺激联合药物疗法组（C组）。每组各74例患者。观察3组患者盆底肌力、盆底肌电活动评分、尿动力学、并发症及生活质量。 结果干预后C组盆底肌力等级较A、B组显著升高（P<0.05）,A、B组比较差异无统计学意义（P=0.952）;干预后3组盆底肌电活动评分及生活质量（SF-36）评分均升高,C组指标均优于A、B组（P<0.05）,A、B组比较差异均无统计学意义（P=0.118,P=0.881）;干预后3组尿动力学指标均升高,且C组指标均显著高于A、B组（P<0.05）,A、B组比较差异均无统计学意义（P=0.621,P=0.668,P=0.306）;干预后C组并发症总发生率明显低于A、B组（P<0.05）。 结论生物反馈电刺激技术联合雌二醇凝胶用于绝经后POP患者盆底重建术后疗效显著,可降低并发症发生率。