术前强化提肛肌训练改善经尿道前列腺剜除术后尿失禁的效果分析

Effect of Preoperative Levator Ani Muscle Training on Urinary Incontinence after Transurethral Resection of Prostate

摘要: 目的：探讨术前强化提肛肌训练改善患者术前盆底肌肉收缩力，进而促进经尿道前列腺剜除术后尿失禁恢复的效果。方法：将2018年1月至2018年5月在我院行前列腺增生经尿道前列腺剜除术的88例患者随机分为实验组44例和对照组44例。实验组入院当天开始给予严格的提肛肌训练，并持续到手术前一天行盆底功能评估，拔除尿管后继续给予提肛肌训练到尿失禁缓解为止；对照组术后拔除尿管后才给予提肛肌训练，持续到尿失禁缓解为止。比较两组术后尿失禁发生率，尿失禁严重程度，尿控恢复时间。结果：实验组术前盆底功能明显优于对照组；术后尿失禁发生率为52.6%，低于对照组91% (P < 0.05)；实验组尿失禁严重程度明显低于对照组(P < 0.05)；实验组尿失禁恢复时间显著短于对照组(P < 0.05)。结论：术前强化提肛肌训练可以改善盆底功能，进而显著降低前列腺剜除术后尿失禁的发生率，改善尿失禁严重程度，缩短恢复时间。

Abstract: Objective: To explore the significance of preoperative enhanced levator ani training on the function of pelvic floor and the recovery of urinary incontinence after transurethral resection of prostate. Methods: 88 patients with prostatic hyperplasia and TURP in our hospital from January 2018 to May 2018 were randomly divided into experimental group (44 cases) and control group (44 cases). The experimental group began to give strict enhanced levator ani training on the day of admission, and pelvic floor muscle strength was assessed by pelvic floor myoelectricity physiologic instrument one day before the operation, after the postoperative removal of the catheter, the levator ani training was continued until the urinary incontinence was cured; the control group was given the levator ani muscle training after the postoperative removal of the catheter and continued to the cure of urinary incontinence. After remission, the incidence of postoperative urinary incontinence, the severity of urinary incontinence, and the recovery time of urinary control were compared between the two groups. Results: The pelvic floor function of the experimental group was significantly better than that of the control group. The incidence of postoperative urinary in-continence was 52.6% in experimental group, which was lower than that of the control group (91%; P < 0.05). The severity of urinary incontinence in the experimental group was significantly lower than that of the control group (P < 0.05). The recovery time of urinary incontinence in the experimental group was significantly shorter than that in the control group (P < 0.05). Conclusion: Preoperative levator ani training can improve the function of pelvic floor, which can significantly reduce the incidence of urinary incontinence after prostatectomy, improve the severity of urinary incontinence and shorten the recovery time.