生物刺激反馈联合盆底肌功能锻炼对脑卒中后排尿功能障碍患者的康复效果

目的 探讨生物刺激反馈对脑卒中后排尿功能障碍患者的康复效果.方法 回顾性分析北京电力医院2011年3月～2013年8月采用生物刺激反馈联合常规盆底肌功能锻炼的76例患者（治疗组）和2009年3月～ 2011年2月采用常规盆底肌功能锻炼及康复治疗的69例脑卒中后排尿功能障碍患者（对照组）的临床资料,对两组患者的临床疗效及治疗前后的生活质量精简问卷（SQLP）评分、尿动力学指标、盆底肌群肌电水平进行组间及组内比较.结果 治疗组临床疗效总有效率为89.5％,显著高于对照组的63.8％ （P＜0.05）.治疗组治疗后的SQLP评分为（13.0±2.6）分,显著低于治疗前的（24.9±2.5）分和对照组治疗后的（22.8±2.0）分（均P＜0.05）;膀胱最大收缩压、尿道闭合压力和残余尿量均显著低于治疗前,膀胱充盈初始感觉也较治疗前明显提高（均P＜0.01）,尿动力学指标均显著优于对照组（均P＜0.05）;盆底肌群肌电水平也显著高于治疗前及对照组治疗后的水平（均P＜0.05）.结论 生物刺激反馈联合常规盆底肌功能锻炼及康复治疗对脑卒中后排尿功能障碍患者具有较好的效果.

Effect of biological stimulation feedback combined with pelvic floor muscle exercise on the rehabilitation training on stroke patients with voiding dysfunction

Objective To explore the efficacy of biological stimulation feedback in stroke patients with voiding dysfunction.Methods 76 stroke patients with voiding dysfunction were trained by biological stimulation feedback combined with pelvic floor muscle exercise （treatment group） and 69 similar patients were trained by pelvic floor muscle exercise only （control group） on the rehabilitation.Clinical curative effect,the treatment subjective quality of life profile （SQLP）score,urine dynamics index and pelvic floor muscle electromyography were analyzed.Results The total effective rate of treatment group was significantly higher than that of control group （89.5% vs 63.8%,P〈0.05）.After treatment,the SQLP score of Treatment group （13.0±2.6 point） were significantly lower than before （24.9±2.5 point） and control group （22.8± 2.0 point） （both P〈0.05） ; the bladder maximum systolic pressure,urethral closure pressure and bladder residual urine volume were significantly lower than before,the initial feeling full bladder was increased significantly （P〈0.01）,urine dynamics index were significantly better than that of control group （all P〈0.05） ; pelvic floor muscle electromyography level was also significantly higher than before and the control group （both P〈0.05）.Conclusion Biological stimulation feedback combined with pelvic floor muscle exercise has a good effect on the rehabilitation training on stroke patients with voiding dysfunction.