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中华脑血管病杂志(电子版)

中华脑血管病杂志(电子版) ›› 2024, Vol. 18 ›› Issue (02) : 129 -133. doi: 10.11817/j.issn.1673-9248.2024.02.006

临床研究

盆底肌电刺激联合生物反馈疗法在女性卒中后尿失禁患者中的应用价值
王丽萍1, 聂玉琴2,†(), 朱爱丽3   
  1. 1. 830063　乌鲁木齐，新疆医科大学护理学院；830011　乌鲁木齐，新疆医科大学第五附属医院门诊部
    2. 830092　乌鲁木齐，新疆医科大学第二附属医院护理部
    3. 830092　乌鲁木齐，新疆医科大学第二附属医院妇科
  • 收稿日期:2023-10-04 出版日期:2024-04-01
  • 通信作者: 聂玉琴
  • 基金资助:
    新疆神经系统疾病研究重点实验室开放课题(XJDX1711-2110)

Application value of pelvic floor myoelectric stimulation combined with biofeedback therapy in female patients with post-stroke urinary incontinence

Liping Wang1, Yuqin Nie2,†(), Aili Zhu3   

  1. 1. School of Nursing, Xinjiang Medical University, Urumqi 830063, China; Out-patient Department, the Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China
    2. Department of Nursing, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830092, China
    3. Department of Gynecology, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830092, China
  • Received:2023-10-04 Published:2024-04-01
  • Corresponding author: Yuqin Nie
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王丽萍, 聂玉琴, 朱爱丽. 盆底肌电刺激联合生物反馈疗法在女性卒中后尿失禁患者中的应用价值[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 129-133.

Liping Wang, Yuqin Nie, Aili Zhu. Application value of pelvic floor myoelectric stimulation combined with biofeedback therapy in female patients with post-stroke urinary incontinence[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(02): 129-133.

目的

探讨盆底肌电刺激联合生物反馈疗法对女性脑卒中后尿失禁患者的应用效果。

方法

选取2021年7月至2022年7月新疆医科大学第二附属医院收治的女性脑卒中后尿失禁患者71例为研究对象，按随机数字表法将患者分为试验组（35例）和对照组（36例）。对照组实施常规治疗，试验组在对照组治疗基础上，给予盆底肌电刺激联合生物反馈疗法，经2种不同治疗方式后，采用t检验比较2组患者盆底肌表面肌电（前静息阶段、快速收缩阶段、耐力收缩阶段）数值的差异，采用秩和检验比较国际尿失禁咨询委员会问卷简表（ICI-Q-SF）和一般自我效能感量表（GSES）得分的差异。

结果

治疗后，与对照组比较，试验组盆底肌表面肌电前静息阶段的前基线平均值较对照组减少[（5.22±2.76）μV vs（6.27±2.75）μV]、耐力收缩阶段的慢肌耐力收缩平均值较对照组增高[（19.84±6.22）μV vs（14.90±5.00）μV]，差异均具有统计学意义（t=-3.124、3.694，P=0.003、＜0.001）；快速收缩阶段的快肌收缩最大值较对照组增高[（53.81±17.49）μV vs（45.16±17.70）μV]，差异有统计学意义（t=2.071，P=0.042）。GSES评分较对照组增高[23.00（20.00，27.00）分 vs 17.00（15.00，21.00）分]，ICI-Q-SF评估得分较对照组减少[8.00（5.00，9.00）分 vs 9.00（6.25，11.00）分]，差异均具有统计学意义（Z=-3.959、-1.974，P＜0.001、=0.048）。

结论

盆底肌电刺激联合生物反馈疗法能改善女性脑卒中患者尿失禁的症状。

关键词: 脑卒中, 尿失禁, 盆底肌电刺激, 生物反馈疗法
Objective

To investigate the application effects of pelvic floor myoelectric stimulation combined with biofeedback therapy on female post-stroke urinary incontinence patients.

Methods

A total of 71 female post-stroke urinary incontinence patients admitted to the Second Affiliated Hospital of Xinjiang Medical University from July 2021 to July 2022 were included. They were divided into the experimental group (35 cases) and the control group (36 cases) using a random number table. The control group underwent conventional treatment, while the experimental group received pelvic floor myoelectric stimulation combined with biofeedback therapy plus the conventional treatment. After undergoing the two different treatment methods, the surface electromyography values of pelvic floor muscles (baseline during quiet rest, maximum value during fast contraction, average value during endurance contraction), scores on the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF), and General Self-Efficacy Scale (GSES) were compared between the two groups. For normally distributed data, t-tests were used; for non-normally distributed data, the Mann-Whitney U test was employed.

Results

Compared with the control group, the experimental group had a lower pre-baseline mean value of surface electromyography of the pelvic floor muscles during the pre-resting phase [(5.22±2.76) μV vs (6.27±2.75) μV], a higher mean endurance contraction value during the slow twitch endurance contraction phase [(19.84±6.22) μV vs (14.90±5.00) μV], the differences were statistically significant (t=-3.124, 3.694, P=0.003, <0.001); however the maximum muscle contraction in the experimental group was significantly higher than that in the control group during the rapid contraction phase [(53.81±17.49) μV vs (45.16±17.70) μV], the difference was statistically significant (t=2.071, P=0.042). The GSES score in the experimental group was higher than that of the control group [23.00 (20.00,27.00) vs 17.00 (15.00, 21.00)], and the ICI-Q-SF assessment score in the experimental group was lower than that of the control group [8.00 (5.00,9.00) vs 9.00 (6.25, 11.00)], the differences were statistically significant (Z=-3.959, -1.974, P＜0.001, =0.048).

Conclusion

Pelvic floor myoelectric stimulation combined with biofeedback therapy can effectively alleviate the symptoms of urinary incontinence in female post-stroke patients.

Key words: Stroke, Urinary incontinence, Pelvic floor myoelectric stimulation, Biofeedback therapy
表1 2组脑卒中后尿失禁患者治疗前后盆底表面肌电评估比较（μV，
x ¯
±s）
组别 例数 前基线平均值 t值 P值 快肌收缩最大值 t值 P值 慢肌耐力收缩平均值 t值 P值
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
试验组 35 7.33±4.02 5.22±2.76 8.453 ＜0.001 38.31±18.88 53.81±17.49 -4.456 ＜0.001 13.39±5.37 19.84±6.22 -11.95 ＜0.001
对照组 36 7.16±3.09 6.27±2.75 4.295 ＜0.001 43.06±17.41 45.16±17.70 -3.246 ＜0.001 11.46±2.97 14.90±5.00 -7.923 ＜0.001
t值 0.201 -3.124 -1.104 2.071 1.879 3.694
P值 0.841 0.003 0.274 0.042 0.064 ＜0.001
表2 2组脑卒中后尿失禁患者治疗前后一般自我效能感量表得分比较[分，M（QR）]
组别 例数 治疗前 治疗后 Z值 P值
试验组 35 18.00（16.00，20.00） 23.00（20.00，27.00） 5.035 ＜0.001
对照组 36 15.00（13.30，17.80） 17.00（15.00，21.00） 4.405 ＜0.001
Z值 -0.654 -3.959
P值 0.513 ＜0.001
表3 2组脑卒中后尿失禁患者治疗前后ICI-Q-SF得分比较[分，M（QR）]
组别 例数 治疗前 治疗后 Z值 P值
试验组 35 13.00（11.00，15.00） 8.00（5.00，9.00） -5.068 ＜0.001
对照组 36 12.00（10.25，15.75） 9.00（6.25，11.00） -5.222 ＜0.001
Z值 -0.631 -1.974
P值 0.528 0.048
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