不同盆底康复治疗方案对产后压力性尿失禁康复的疗效分析【摘要】目的：观察不同的盆底康复治疗方案对产后压力性尿失禁康复的疗效对比分析。方法：选择在本院2013年9月-2015年9月住院分娩、产后12周内出现尿失禁症状的初产妇330例，根据患者的治疗意愿纳入观察组和对照组，每组各165例。对照组接受生物反馈电刺激疗法，观察组在对照组治疗方案基础上增加凯格尔（Kegel）运动配合阴道哑铃实施盆底功能训练。比较两组治疗前后的盆底肌力、尿失禁程度评分、lh尿垫试验检测漏尿量及经会阴三维超声检测的变化及3个月后的治疗效果。结果：治疗后两组各观察指标均冇所改善，观察组改善趋势更为明显,两组比较差异均有统计学意义（P〈0.05）。治疗结束3个月后评价疗效，观察组尿失禁治愈率77.18%,对照组治愈率67.83%,观察组疗效明显高于对照组，两组比较差异冇统计学意义（P〈0・05）。结论：两种不同的盆底康复治疗方案对产后压力性尿失禁均有康复效果，生物反馈电刺激疗法联合盆底功能训练可明显改善产后压力性尿失禁的症状和预后，冇效提高产后妇女的生殖健康和生活质量，建议推广应用。【关键词】盆底康复治疗；产后压力性尿失禁；盆底功能训练[Abstract]Objective:Toanalyzethecurativeeffectofdifferentpelvicfloorrehabilitationtreatmentforpostpartumstressurinaryincontinencerehabilitation.Method：330casesofprimiparawithsymptomsofurinaryincontinence12weeksafterparturitioninourhospitalwereselectedfromSeptember2013toSeptember2015・Allpatientsweredividedintoobservationgroupandcontrolgroup,165casesineachgroup,accordingtothetreatmenttheychosenastheirintention.Thecontrolgroupreceivedbiofeedbackelectricalstimulationtherapy,observationgroupreceivedpelvicfloorfunctionaltrainingofKegelexercisecooperatevaginaldumbbellonthebasisofcontrolgroup.Pelvicfloormusclestrength,thedegreeofincontinencescore,1hurineleakageofurinepadtest,thechangeoftheperineumthree-dimensionalultrasonictestingandtreatmenteffectafter3monthsoftwogroupswerecomparedbeforeandafterthetreatment.Result：Aftertreatmenttheindexesofbothtwogroupschangedbetterthanbefore,butthoseofobservationgroupimprovedmoreobviousthanwhichofcontrolgroup,thedifferenceswerestatisticallysignifiednt(P<0.05).After3monthsoftreatment,thecurerateofobservationgroupwas77.18%,andthecurerateofcontrolgroupwas67.83%,thecurativeeffectofobservationgroupwassignificantlyhigherthanthatofcontrolgroup,thedifferencewasstatisticallysignificant(P〈0.05)・Conclusion:Thetwodifferenttypesofpelvicfloorrehabilitationtreatmentofpostpartumstressurinaryincontinencehaverehabilitationeffect.biofeedbackelectricalstimulationthempyincombinationwithpelvicfloorfunctiontrainingcanobviouslyimprovethesymptomsandprognosisofpostpartumstressurinaryincontinence,effectivelyimprovethereproductivehealthofpostpartumandqualityoflifeofwomen,recommendingpopularizedapplication.[Keywords]Pelvicfloorrehabilitationtreatment；Stressurinaryincontinece；PostpartumpelvictrainingFirst-author?saddress：Qingj^uanCityPeople?sHospital,Qingyuan511518,Chinadoi：10.3969/j.issn.1674-4985.2016.19.001妊娠和分娩可在一定程度上导致盆底支持组织松弛而出现女性盆底功能障碍性疾病(pelvicfloordysfunction,PFD),最常见的是压力性尿失禁(stressurinarincontinence,SUI),使产妇的生活质量大大降低。SUI发生时并未出现逼尿肌收缩或膀胱张力增加，笔者认为早期及时应用康复措施可部分甚至完全扭转病情[1-4]o近年来随着SUI研究的日益加深，多种治疗手段均被发现具冇理想的治疗效果，非手术疗法为首选,其中接受程度最广泛的当属盆底功能训练或者生物反馈电刺激。本研究利用生物反馈电刺激疗法联合盆底功能训练安全有效地改善了SUI的临床症状，对盆底功能的恢复起到促...