行为疗法治疗女性轻中度压力性尿失禁的疗效观察

[目的]观察行为疗法治疗女性轻、中度压力性尿失禁的效果.[方法]选择31例女性压力性尿失禁病人,进行行为训练,包括盆底肌锻炼、尿急训练、膀胱功能训练、生活方式干预.治疗观察12周,评价其疗效.[结果]轻度组总有效率91.3%,中度组总有效率62.5%.[结论]行为疗法对女性轻、中度压力性尿失禁治疗效果满意.     

肌电刺激联合生物反馈治疗女性轻中度压力性尿失禁的疗效观察

[目的]探讨肌电刺激联合生物反馈治疗女性轻、中度压力性尿失禁(SUI)的疗效.[方法]选择2013年2月至2016年2月在本院诊治的女性轻、中度SUI患者362例,按患者的治疗意愿分为观察组和对照组,每组181例.观察组行肌电刺激联合生物反馈治疗,对照组行Kegel训练,所有患者持续治疗8周.治疗后评价治疗效果和盆底肌功能.[结果]治疗后,两组患者的盆底肌功能均呈现不同程度恢复,评分高于治疗前(P<0.05);观察组盆底肌力评分显著高于对照组(P<0.05);观察组总有效率为91.16%,明显高于对照组72.93%(P<0.05).[结论]肌电刺激联合生物反馈治疗轻、中度SUI临床效果切实有效,安全性高,操作简单,值得临床推广.     

日记式康复指导对女性压力性尿失禁患者盆底肌锻炼依从性的影响

目的探讨日记式康复指导对女性压力性尿失禁患者盆底肌锻炼依从性的影响。方法选取2017年12月至2018年12月我院收治的96例女性压力性尿失禁患者作为研究对象,随机将其等分为对照组和试验组,对照组给予常规康复干预,试验组在对照组基础上给予日记式康复指导。采用国际尿失禁咨询委员会尿失禁问卷调查简表(ICI-Q-SF)评估患者尿失禁症状的主观改善情况,比较两组患者干预前、干预后3个月自我效能得分、盆底肌锻炼依从性、主观改善情况、临床治疗效果。结果干预后3个月,两组患者自我效能得分均明显升高,试验组得分明显高于对照组(P<0.05);干预后3个月,两组患者盆底肌锻炼依从性均明显改善(P<0.05),试验组优于对照组(P<0.05);干预后3个月,两组ICI-Q-SF评分均明显降低,试验组低于对照组(P<0.05);试验组临床治疗效果明显高于对照组(P<0.05)。结论日记式康复指导能够明显提升女性压力性尿失禁患者盆底肌锻炼依从性,增强患者自我效能,有效改善尿失禁症状,明显提高临床治疗效果。     

认知行为干预对女性压力性尿失禁患者盆底肌训练依从性和治疗效果的影响

目的:探讨认知行为干预对轻中度女性压力性尿失禁患者盆底肌训练依从性和治疗效果的影响。方法:选择88例轻中度压力性尿失禁患者,按照抽签方法随机分为观察组45例和对照组43例,分别对两组患者入组前及入组后2周,1,2,3个月进行1 h尿垫试验和采用国际尿失禁咨询委员会尿失禁问卷表简表评估尿失禁次数和量,采用尿失禁生活质量问卷(QOL)评估对生活质量的影响。结果:入组1,2,3个月干预组患者依从性明显较对照组提高,疗效明显比对照组好,差异具有统计学意义(P0.05)。结论:对轻中度尿失禁患者进行认知行为干预能保证患者的依从性,且临床疗效明显。     

中西医结合治疗联合护理干预对绝经期女性压力性尿失禁的效果观察

目的探讨中西医结合治疗联合护理行为干预对绝经期女性压力性尿失禁的效果。方法按抽签法将100例绝经期女性压力性尿失禁患者随机分为观察组和对照组,各50例。观察组通过中西医结合治疗联合护理行为干预对纳入研究对象进行为期6个月的综合干预,对照组按照中西医结合治疗后并进行相关的健康宣教,以患者自主意识为主。结果 6个月后,两组绝经期女性压力性尿失禁患者均有不同程度的缓解,且观察组的尿失禁生活质量量表各维度评分与对照组相比均有不同程度地提高,差异具有统计学意义(P0.05)。结论中西医结合联合行为干预治疗绝经期女性压力性尿失禁具有无风险,又能减轻症状并提高此类人群生活质量的优点。     

个体化盆底康复治疗老年女性轻、中度压力性尿失禁患者的临床观察

目的探讨个体化盆底康复对老年女性轻中度真性压力性尿失禁患者的影响。方法将确诊的老年女性轻、中度真性压力性尿失禁患者60例随机分为2组各30例,均给予常规康复治疗;观察组在常规康复治疗基础上给予个体化盆底康复措施,比较治疗前后各项临床指标、尿失禁症状评分、生活质量以及护理满意度。结果观察组患者治疗后的最大尿道压、最大尿道关闭及尿失禁症状评分得到改善(P0.05);观察组治疗后的躯体功能、生理功能等生活质量评分高于对照组(P0.05);且观察组治疗后患者满意度高于对照组(P0.05)。结论个体化盆底康复在老年女性轻、中度真性压力性尿失禁中的应用,能够促进患者症状改善,提升生活质量,患者满意度高,值得推广应用。     

女性压力性尿失禁患者生活质量的影响因素分析

目的研究女性压力性尿失禁患者生活质量的影响因素并探讨行为干预对生活质量的改善作用。方法对154例就诊的压力性尿失禁的患者,应用"一般资料调查表"及"尿失禁生活质量量表"对两组患者进行问卷调查,采用多元回归方法分析女性压力性尿失禁患者生活质量的影响因素。154例患者按入院顺序随机分为观察组和对照组,对照组患者接受健康教育,观察组患者在健康教育的基础上接受行为干预,6个月后比较两组患者的生活质量评分。结果多元回归分析显示,体质指数、经济情况、尿失禁严重程度、产次、慢性呼吸系统疾病、便秘,是影响压力性尿失禁患者的重要因素。治疗前观察组和对照组的生活质量评分差异无显著意义(P<0.01),经过3个月治疗后,两组患者的生活质量评分均显著升高(P<0.01),观察组患者的生活质量评分显著高于对照组(P<0.01)。结论影响女性压力性尿失禁患者生活质量的因素较多,控制体重、积极治疗并发症,有助于改善患者的生活质量,行为干预可显著提高女性压力性尿失禁患者的生活质量。     

生物反馈电刺激联合Kegel运动治疗老年女性轻中度压力性尿失禁的效果

目的 研究生物反馈电刺激(BES)联合Kegel运动在老年女性轻中度压力性尿失禁(SUI)患者治疗中的应用价值。方法 选取2019年1月至2021年1月三门峡市中医院收治的106例老年女性轻中度压力性尿失禁患者为研究对象。根据治疗方法不同分为对照组与观察组,每组53例。两组均给予基础干预,对照组予以Kegel运动疗法,观察组予以Kegel运动联合BES治疗。比较两组治疗3个月后治疗效果、盆底肌力、尿失禁(Sandvik)改善情况、尿失禁生活质量量表(I-QOL)评分及1 h尿垫实验。结果 治疗后,观察组治疗总有效率(94.34%,50/53)较对照组(67.92%,36/53)高(t=12.079,P<0.01)。治疗前,两组慢肌、快肌肌力比较,差异未见统计学意义(P>0.05);治疗后,两组慢肌、快肌肌力上升,观察组较对照组高(P<0.05)。治疗前,两组1 h尿垫重量、Sandvik严重程度、I-QOL评分比较,差异未见统计学意义(P>0.05);治疗后,两组I-QOL评分均升高,且观察组高于对照组(P<0.05),两组Sandvik严重程度、1 h尿...     

King互动达标理论对老年压力性尿失禁患者盆底肌训练依从性的影响

目的 探讨King互动达标理论对老年压力性尿失禁患者盆底肌训练依从性的影响。方法 按照随机数字表法将2018年1月至2019年2月河池市妇幼保健院收治的100例老年压力性尿失禁盆底肌训练患者分为对照组和观察组各50例，对照组给予压力性尿失禁常规护理，观察组将King互动达标理论应用于护理干预中，观察比较两组患者干预后盆底肌训练依从情况，以及干预前和干预后两组患者最大尿道压（MUP）、最大尿道关闭压（MUCP）。结果 观察组患者干预后盆底肌训练依从率高于对照组（96% vs. 70%）（P＜0.01）。干预前两组患者MUP和MUCP差异无统计学意义（P＞0.05）；干预6个月后，两组患者MUP和MUCP均较干预前提高，且干预组高于对照组（P＜0.01）。结论 King互动达标理论用于老年压力性尿失禁护理干预中能提高患者盆底肌训练依从性，促进患者膀胱和尿道功能的康复，值得临床推广应用。     

盆底肌训练(Kegel操)在女性压力性尿失禁术后的应用体会

目的：探讨盆底肌训练(Kegel操)对女性压力性尿失禁患者术后症状及生活质量的影响。方法：选择2014年1月至11月间诊断为中重度压力性尿失禁,同时行TVT术的女性患者,术后将其随机分为干预组(Kegel操 健康宣教)和对照组(健康宣教),于术后1、6、12个月分别对两组患者的尿失禁症状、生活质量及Glazer盆底表面肌电进行评估。结果：术后12个月两组患者在尿失禁症状评分、Glazer盆底表面肌电评估、生活质量评分上存在统计学差异(P<0.05),而术后6个月未能体现出明显差异(P＞0.05)。同时术后12月时干预组的临床有效率明显高于对照组。结论：对于中重度压力性尿失禁的女性患者,在TVT术后长期结合盆底肌训练有利于增强盆底肌肉群的肌力,提高表面肌电评分,从而明显改善尿失禁的临床症状,有助于改善患者的预后及治疗的有效率。     

Effects of Co-contraction of Both Transverse Abdominal Muscle and Pelvic Floor Muscle Exercises for Stress Urinary Incontinence: A Randomized Controlled Trial

[Purpose] The purpose of this study was to devise a new urinary incontinence exercise using co-contraction of both the transverse abdominal muscle (TA) and pelvic floor muscle (PFM) and examine the intervention effect in middle-aged women with stress urinary incontinence (SUI). [Subjects] The subjects were fifteen women with SUI who were divided into two groups: the TA and PFM co-contraction exercise group (n=9) and the control group (n=6). [Methods] Participants in the exercise group performed TA and PFM co-contraction exercise. The thickness of the TA was measured before and after 8 weeks of exercise using ultrasound. The thickness of the TA was measured under 4 conditions: (1) at rest, (2) maximal contraction of the TA, (3) maximal contraction of the PFM, and (4) maximal co-contraction of both the TA and PFM. [Results] There were no significant differences among the results of the control group. In the exercise group, the cure rate of SUI was 88.9% after the intervention. There were significant differences in the thickness of the TA during maximal co-contraction of both the TA and PFM after the intervention. [Conclusion] The TA and PFM co-contraction exercise intervention increases the thickness of the TA and may be recommended to improve SUI in middle-aged women.Key words: Stress urinary incontinence, Transverse abdominal muscle, Exercise     

盆底肌肉功能锻炼治疗女性轻中度压力性尿失禁的临床研究

目的观察盆底肌肉功能锻炼治疗女性轻、中度压力性尿失禁(SUI)的临床疗效,为寻找合适的治疗方法提供理论参考。方法将107例轻、中度SUI患者随机分为治疗组和对照组。对照组采用常规药物治疗,治疗组采用盆底肌肉功能锻炼治疗。连续治疗12周后评价临床疗效,观察治疗前后两组患者尿动力学指标的变化。结果 (1)两组患者的最大尿流率、平均尿流率与治疗前比较显著下降(P0.05)。两组患者的排尿时间、功能性尿道长、最大尿道关闭压与治疗前比较显著上升(P0.05),且治疗组与对照组比较均有显著性差异(P0.05);(2)治疗组临床疗效总有效率为92.2%,显著高于对照组(P0.05)。结论盆底肌肉功能锻炼是轻、中度女性SUI患者的首选治疗方法 ,值得临床推广应用。     

电刺激生物反馈联合综合运动疗法治疗中老年轻、中度压力性尿失禁患者的临床疗效

[目的]探讨电刺激生物反馈联合综合运动疗法治疗中老年轻、中度压力性尿失禁(SUI)患者的临床疗效.[方法]选取2018年6月至2020年6月在本院诊治的中老年轻、中度S U I患者80例为研究对象,按照随机数表法分为观察组和对照组,每组40例.观察组给予电刺激生物反馈联合综合运动疗法[腹式呼吸+桥式运动+凯格尔运动(K...     

Intrinsic Motivation Inventory: translation and validation in Chinese women with urinary incontinence

Female stress urinary incontinence can be treated through surgical, pharmacological and non-surgical approaches. The behavioural intervention such as pelvic floor muscle exercise in the treatment of stress urinary incontinence had been widely studied with a cure rate from 25% to 56%. To date, there is no instrument to measure the intrinsic motivation of Chinese women with stress urinary incontinence engaged in pelvic floor muscle exercise. The aim of the study is to translate the Intrinsic Motivation Inventory (IMI) into Chinese and evaluate the psychometric properties of the Chinese version. Hong Kong Chinese women ( n = 150) attending the pelvic floor muscle exercise programme participated in this study. Test–retest reliability and validity of the C-IMI was assessed. Correlation between the C-IMI and the Chinese version of the Rosenberg self-esteem (C-RES) was used for criterion validity. Construct validity was examined using factor analysis. Cronbach alpha for the IMI-C was 0·79 and test–retest reliability was 0·66. C-IMI was correlated with C-RES score ( r = 0·25, < 0·01). The factor analysis provided five factors and accounted for 60·8% of variance. The C-IMI could be used to help to identify people with low motivation related to adherence to pelvic floor muscle exercise, monitor intervention outcomes and improve exercise behaviour of patients not only with urinary incontinence but also in other patients who require exercise regime as a health-promotion intervention such those undergoing cardiac rehabilitation.     

康复日记联合情景演练式健康指导在产后压力性尿失禁患者中应用

目的 探讨康复日记联合情景演练式健康指导在产后压力性尿失禁患者盆底肌功能锻炼中的应用效果。方法 选取2018年1 -12月我院收治的90例产后压力性尿失禁患者,采用随机数字表法将其分为观察组及对照组,每组各45例。2组均给予盆底肌功能训练,对照组行常规健康指导,观察组行康复日记联合情景演练式健康指导。结果 观察组疾病知识知晓率、锻炼依从率、治疗有效率均高于对照组(χ²=12.180,P＜0.001;χ²=10.879,P=0.001;χ²=12.180,P＜0.001)。干预后,观察组Ⅰ类肌力、Ⅱ类肌力评分均高于对照组(t=7.541,P＜0.001;t=7.698,P＜0.001)。观察组行为限制、社交尴尬、对心理影响及生活质量量表总评分均高于对照组(P＜0.001)。结论 目标康复日记联合情景演练式健康指导能有效提高产后压力性尿失禁患者盆底肌功能锻炼依从性,改善患者盆底肌功能,提高患者生活质量。     

The effects of multidimensional exercise treatment on community-dwelling elderly Japanese women with stress, urge, and mixed urinary incontinence: a randomized controlled trial

Background

Urinary incontinence is one of the most prevalent health problems and a significant cause of disability and dependence in the elderly. Pelvic floor exercise is effective in reducing stress urinary incontinence, but few studies have investigated the effect of behavioral management on urge and mixed incontinence.

Objectives

To determine the effects of multidimensional exercise treatment on reducing urine leakage in elderly Japanese women with stress, urge, and mixed urinary incontinence.

Design

Randomized controlled, follow-up trial.

Settings

Urban community-based study.

Participants

127 community-dwelling women aged 70 and older with stress, urge, and mixed urinary incontinence were randomly assigned to the intervention (n = 63) or the control group (n = 64).

Methods

Urine leakage and fitness data were collected at baseline, and after the intervention and follow-up. The intervention group received a multidimensional exercise treatment twice a week for 3-month. After treatment, the participants were followed for 7-month.

Results

There were significant differences in changes of functional fitness and incontinence variables between the intervention and control groups. The intervention group showed urine leakage cure rates of 44.1% after treatment and 39.3% after follow-up (χ² = 21.96, p < 0.001); whereas, the control group showed no significant improvement. The multidimensional exercise treatment was significantly effective in decreasing all three types of urinary incontinence. However, the effects of the exercise treatment were greater on stress urinary incontinence than on urge or mixed urinary incontinence. At the 7-month follow-up, while cure rates of all three types of urinary incontinence were significantly maintained, a slight reversal was seen only in the urge and mixed urinary incontinence (χ² = 10.28, p = 0.008). According to the logistic regression model, urine leakage volume (adjusted odds ratio OR = 0.69, 95% confidence interval CI = 0.39–0.98), compliance (OR = 1.03, 95%CI = 1.01–1.16), and BMI reduction (OR = 0.67, 95%CI = 0.48–0.89) were significantly associated with the cure of urine leakage after intervention. The cure rate of urine leakage after the follow-up was significantly associated with compliance (OR = 1.13, 95%CI = 1.02–1.29) and BMI reduction (OR = 0.78, 95%CI = 0.60–0.96).

Conclusions

The intervention group showed higher urine leakage cure rates than control group. This result suggests that multidimensional exercise strategies may be effective for all three types of urinary incontinence. BMI reduction and compliance to the intervention was the consistent predictor for the effectiveness of the exercise treatment.     

Kegel盆底肌训练治疗产后尿失禁35例效果观察

目的:探讨Kegel盆底肌训练治疗产后尿失禁的效果。方法:将67例自然分娩初产妇随机分为实验组35例和对照组32例,实验组于产后3个月开始进行12周的产后健康教育和Kegel盆底肌训练指导,对照组给予常规健康教育,两组均于产后3个月、6个月进行随访,通过问卷调查、盆底肌力测定及尿垫试验评价其排尿情况。结果:产后3个月两组排尿状况评分、盆底肌力评分、尿失禁发生率比较差异均无统计学意义(P>0.05),产后6个月两组比较差异均有统计学意义(P<0.05)。结论:Kegel盆底肌训练能有效治疗产后尿失禁。     

电针刺激联合盆底肌训练治疗脑梗死后尿失禁43例效果观察

目的:探讨电针刺激联合盆底肌训练治疗脑梗死后尿失禁患者的效果.方法:将86例脑梗死后尿失禁患者随机分为实验组和对照组各43例,对照组给予单纯盆底肌训练,实验组采用电针刺激联合盆底肌训练.结果:实验组痊愈率、总有效率均高于对照组(P<0.05).结论:在科学的护理指导下,对脑梗死后尿失禁患者采取电针刺激和功能锻炼相结合的方法,可达到更理想的康复效果.