产后压力性尿失禁患者生物反馈电刺激联合综合康复护理临床效果

Clinical Effect of Biofeedback Electrical Stimulation Combined with Comprehensive Rehabilitation Nursing in Patients with Postpartum Stress Urinary Incontinence

摘要: 目的：探讨生物反馈电刺激联合综合康复护理(凯格尔运动 + 呼吸训练 + 膀胱功能管理 + 悬吊训练 + 健康教育 + 随访跟踪)临床效果，旨在探索科学、高效的康复护理方案。方法：本研究采用随机抽样法选取于2024年5月至2025年5月在延安市安塞区妇幼保健院和安塞区人民医院妇产科门诊部就诊的患者。采用随机对照试验(RCT)，将符合条件的研究对象分为两组：对照组采用常规护理(健康教育 + 凯格尔运动指导)；干预组采用综合康复护理(生物反馈电刺激 + 凯格尔运动 + 呼吸训练 + 膀胱功能管理 + 悬吊训练 + 健康教育 + 随访跟踪)。计量资料采用均数 ± 标准差或中位数与四分位数表示，组间比较用t检验或非参数检验；计数资料用卡方检验或Fisher精确检验；产后压力性尿失禁患者生物反馈电刺激联合综合康复护理干预结束后1个月、3个月ICI-Q-SF评分采用重复测量方差分析；显著性水平设定为α = 0.05。结果：产后合并压力性尿失禁患者实施生物反馈电刺激联合综合康复护理干预8周结束后，其1个月、3个月ICI-Q-SF问卷评分低于对照组患者，差异具有统计学意义(P < 0.05)；产后压力性尿失禁患者生物反馈电刺激联合综合康复护理干预实施后3个月漏尿量为少量漏尿的患者占比为37.9%，中等量漏尿患者占比为1.7%，较综合康复护理干预实施前明显减少，较对照组少，且不漏尿患者较对照组显著增多，差异具有统计学意义(P < 0.05)；产后压力性尿失禁患者生物反馈电刺激联合综合康复护理干预结束后3个月盆底肌力平均为4.0 (4.0, 5.0)级，高于对照组患者4.0 (3.0, 4.0)级 (z = −3.420, P = 0.001)，差异具有统计学意义。结论：本研究显示，生物反馈电刺激联合综合康复护理(涵盖凯格尔运动、呼吸训练、膀胱功能管理、悬吊训练、健康教育及随访跟踪)在改善盆底功能障碍患者的临床结局中具有显著效果。PSUI的干预策略逐渐从单一局部治疗转向整体康复模式，强调盆腹动力学平衡、核心肌群稳定性及生活方式的综合管理。

Abstract: Objective: To explore the clinical effect of biofeedback electrical stimulation combined with comprehensive rehabilitation nursing (Kegel exercise + respiratory training + bladder function management + suspension training + health education + follow-up tracking), aiming to explore a scientific and efficient rehabilitation nursing plan. Method: In this study, patients who visited the Obstetrics and Gynecology Outpatient Department of Ansai District Maternal and Child Health Hospital and Ansai District People’s Hospital in Yan’an City from May 2024 to May 2025 were selected by random sampling. A randomized controlled trial (RCT) was adopted, and the eligible research subjects were divided into two groups: The control group received conventional care (health education + Kegel exercise guidance); the intervention group adopted comprehensive rehabilitation nursing (biofeedback electrical stimulation + Kegel exercise + respiratory training + bladder function management + suspension training + health education + follow-up tracking). Measurement data were expressed as mean ± standard deviation or median and quartiles. T-tests or non-parametric tests were used for comparison between groups. Counting data were tested by chi-square test or Fisher’s exact test; repeated measures analysis of variance was used for the ICI-Q-SF scores of patients with postpartum stress urinary incontinence one month and three months after the biofeedback electrical stimulation combined with comprehensive rehabilitation nursing intervention. The significance level was set at α = 0.05. Results: After 8 weeks of biofeedback electrical stimulation combined with comprehensive rehabilitation nursing intervention for postpartum patients with stress urinary incontinence, the ICI-Q-SF questionnaire scores at 1 month and 3 months were lower than those of the control group patients, and the difference was statistically significant (P < 0.05). Three months after the implementation of biofeedback electrical stimulation combined with comprehensive rehabilitation nursing intervention for postpartum stress urinary incontinence patients, the proportion of patients with a small amount of urine leakage was 37.9%, and the proportion of patients with moderate urine leakage was 1.7%. This was significantly lower than that before the implementation of comprehensive rehabilitation nursing intervention and less than that of the control group. Moreover, the number of patients without urine leakage was significantly higher than that of the control group. The difference was statistically significant (P < 0.05); three months after the end of biofeedback electrical stimulation combined with comprehensive rehabilitation nursing intervention in patients with postpartum stress urinary incontinence, the average pelvic floor muscle strength was 4.0 (4.0, 5.0) grade, which was higher than 4.0 (3.0, 4.0) grade in the control group (z = −3.420, P = 0.001), and the difference was statistically significant. Conclusion: This study shows that biofeedback electrical stimulation combined with comprehensive rehabilitation nursing (covering Kegel exercise, respiratory training, bladder function management, suspension training, health education and follow-up tracking) has a significant effect in improving the clinical outcomes of patients with pelvic floor dysfunction. The intervention strategy for PSUI has gradually shifted from a single local treatment to a holistic rehabilitation model, emphasizing the comprehensive management of pelvic and abdominal dynamic balance, core muscle group stability, and lifestyle.