盆底功能训练在产后压力性尿失禁患者中应用的范围综述

A Scoping Review of Pelvic Floor Functional Training in Patients with Postpartum Stress Urinary Incontinence

摘要: 目的：本研究旨在通过范围综述的方法，系统梳理盆底功能训练在产后压力性尿失禁(SUI)患者中的临床应用现状，重点阐明其干预方案、评估工具及实施效果，以期为优化临床实践策略提供循证依据。方法：以Arksey等制订的范围综述为方法学框架，系统检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方、维普和中国生物医学数据库(CBM)中关于产后发生压力性尿失禁患者盆底功能训练的文献，并由两名研究员对纳入的文献进行筛选、汇总和分析。结果：共纳入27篇文献，盆底功能训练类型包括单一的盆底肌训练及盆底肌训练与其他物理治疗方法的组合；训练的持续时长、频次及强度通常依据所选训练方式、个体体能及承受力进行调整，常见安排为每日3次，每次15~30分钟，整个干预周期多为8~12周；结局指标涵盖疗效指标、效率指标及生活治疗指标3个方面。结论：针对产后出现压力性尿失禁的女性，盆底功能训练呈现出灵活多样和个体化的趋势，能有效缓解相关症状，提升其整体生活品质。未来研究应注重构建最佳盆底功能训练策略，制定规范统一的评价指标体系，并开展更多大样本、高质量的随机对照试验以验证其应用效果。

Abstract: Objective: This study aims to systematically review the current clinical application status of pelvic floor function training in patients with postpartum stress urinary incontinence (SUI) through a scope review method, with a focus on clarifying its intervention plans, assessment tools and implementation effects, in order to provide an evidence-based basis for optimizing clinical practice strategies. Methods: Using the scoping review methodology established by Arksey et al., a systematic search was conducted in PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, VIP, and the Chinese Biological Medicine Database (CBM) for studies on pelvic floor functional training in postpartum women with stress urinary incontinence. Two researchers screened, summarized, and analyzed the included studies. Results: A total of 27 studies were included. The types of pelvic floor functional training included both single pelvic floor muscle training and the combination of pelvic floor muscle training with other physical therapy methods. The training duration, frequency, and intensity were determined based on the type of pelvic floor functional training, the patients’ physical function status, and their tolerance. The training typically lasted 15~30 minutes per session, three times per day, for 8~12 weeks. The outcome indicators included three aspects: efficacy indicators, efficiency indicators, and quality of life indicators. Conclusions: For women who experience stress urinary incontinence after childbirth, pelvic floor function training shows a trend of flexibility, diversity and individualization, which can effectively alleviate related symptoms and improve their overall quality of life. Future research should focus on constructing the best pelvic floor function training strategy, formulating a standardized and unified evaluation index system, and conducting more large-sample, high-quality randomized controlled trials to verify its application effect.