摘要
目的 探讨多元化干预措施对中年女性压力性尿失禁中的疗效及影响因素研究，为后续临床应用提供参考价值。方法 选取2020年10月-2024年12 月在包头市某三甲医院收治200例的中老年女性压力性尿失禁患者为研究对象，依据治疗方式可以分为4组分别为盆底肌训练组、盆底康复仪治疗组，多元化干预策略+盆底肌训练组，多元化干预策略+盆底康复仪治疗组，评估四组实验对象在治疗前、后应用盆底肌评估量表、尿失禁问卷表简表（ICI-Q-SF）、VAS疼痛评分标准、焦虑自评量表（SAS）、生活质量量表（SF-36）等观察患者临床疗效以及评估膀胱功能指标的变化情况。结果 四组患者有效率分别为60.00%、80.00%、70.00%，88.00%，四组之间比较差异有统计学意义（P＜0.05），其中DIS+盆底康复仪组的疗效最优。与治疗前相比，治疗后四组患者 24 h 排尿次数、残余尿量、焦虑评分、1h 尿垫、漏尿次数均显著降低（P<0.05），膀胱容量、每次排尿量、生活质量、会阴肌力均显著增加（P<0.05）。与PFMT治疗组相比，其余三组患者在24 h 排尿次数、残余尿量、焦虑评分、1h 尿垫、漏尿次数均显著降低（P<0.05），膀胱容量、每次排尿量、生活质量、会阴肌力均显著增加（P<0.05）；与盆底康复仪治疗组和DIS+PFMT治疗组相比，DIS+盆底康复仪组患者在24 h 排尿次数、残余尿量、焦虑评分、1h 尿垫、漏尿次数均显著降低（P<0.05），膀胱容量、每次排尿量、生活质量、会阴肌力均显著增加（P<0.05）。结论 四种疗法对中老年女性压力性尿失禁具有治疗效果，尤其是多元化干预策略+盆底康复仪治疗效果最好，可依据患者情况酌情选择。
关键词： 新发压力性尿失禁；疗效；膀胱功能；并发症
Abstract
Objective To explore the therapeutic effect and influencing factors of diversified intervention measures on stress urinary incontinence in middle-aged and elderly women, it was provide reference value for subsequent clinical applications. Methods 200 middle-aged and elderly female patients with stress urinary incontinence admitted to a tertiary hospital in Baotou City from October 2020 to December 2024 were selected as the research subjects. According to the treatment methods, they were divided into four groups: pelvic floor muscle training group, pelvic floor rehabilitation instrument treatment group, diversified intervention strategy+pelvic floor muscle training group, and diversified intervention strategy+pelvic floor rehabilitation instrument treatment group. The four experimental groups were evaluated for their clinical efficacy and changes in bladder function indicators before and after treatment using pelvic floor muscle assessment scale, urinary incontinence questionnaire simplified form (ICI-Q-SF), VAS pain scoring standard, anxiety self-assessment scale (SAS), quality of life scale (SF-36), etc. Results The effective rates of the four groups of patients were 60.00%、80.00%、70.00% and 88.00%, respectively. There was a statistically significant difference between the four groups (P<0.05), and the DIS+pelvic floor rehabilitation instrument group had the best therapeutic effect. Compared with before treatment, the 24-hour urination frequency, residual urine volume, anxiety score, 1-hour urine cushion, and leakage frequency of the four groups of patients significantly decreased after treatment (P<0.05), while bladder capacity, urine volume per urination, quality of life, and perineal muscle strength significantly increased (P<0.05). Compared with the PFMT treatment group, the other three groups of patients showed significant reductions in 24-hour urination frequency, residual urine volume, anxiety score, 1-hour urine cushion, and leakage frequency (P<0.05), while bladder capacity, urine volume per urination, quality of life, and perineal muscle strength were significantly increased (P<0.05); Compared with the pelvic floor rehabilitation device treatment group and the DIS+PFMT treatment group, patients in the DIS+pelvic floor rehabilitation device group showed significant reductions in 24-hour urination frequency, residual urine volume, anxiety score, 1-hour urine cushion, and leakage frequency (P<0.05), as well as significant increases in bladder capacity, urine output per session, quality of life, and perineal muscle strength (P<0.05). Conclusion The four therapy have therapeutic effects on stress urinary incontinence in middle-aged and elderly women, especially the combination of diversified intervention strategies and pelvic floor rehabilitation equipment has the best treatment effect, which can be selected according to the patient's situation.
Key words： Newly developed stress urinary incontinence; Therapeutic effect; Bladder function; Complication
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