阴道哑铃治疗女性压力性尿失禁的研究进展

doi:10.12280/gjfckx.20200578

摘要/Abstract

摘要：

阴道哑铃是一种用于盆底肌肉康复的训练器,可应用于压力性尿失禁（stress urinary incontinence,SUI）的保守治疗或手术治疗的辅助治疗,操作简单,安全性高。与其他SUI的治疗方法不同,阴道哑铃可在医生指导下由患者在家自行使用进行盆底锻炼,降低治疗成本的同时帮助患者提高生活质量。此外,预防性应用阴道哑铃可能会对SUI的高危人群起到良好效果。目前研究发现,阴道哑铃作为一种无创性治疗方法,治疗SUI的疗效具有持久性。然而,还没有阴道哑铃疗效优于其他方法的结论,哪种疗法在SUI的保守治疗领域疗效最佳存在争议。阴道哑铃联合凯格尔运动、生物反馈、电刺激等方法,可能提高SUI康复的概率,适合纳入SUI的联合治疗方案。对阴道哑铃改善SUI的基本原理、使用方法、适用人群、应用现状、疗效等进行综述。

关键词: 阴道哑铃, 尿失禁, 压力性, 盆底肌康复, 保守治疗

Abstract:

Vaginal cone is a kind of equipment used for pelvic floor muscle training. It is often used in conservative and surgical treatment of stress urinary incontinence (SUI) before and after surgery. The operation is simple and safe. Different from other SUI treatment methods, vaginal cone can be used by patients at home for pelvic floor exercises under the guidance of doctors, reducing treatment costs and helping patients improve their quality of life. In addition, the preventive use of vaginal cone may have a good effect on high-risk groups of SUI. Current studies have found that vaginal cone, as a non-invasive treatment method, has a lasting effect on SUI. However, there is no conclusion that vaginal cone is better than other methods, and which therapy has the best effect in the field of conservative treatment of SUI is controversial. Vaginal cone combined with Kegel exercises, biofeedback, electrical stimulation and other methods may increase the probability of SUI recovery, and it is suitable to be included in the combined treatment plan of SUI. This article reviews the basic principles of vaginal cone, methods of use, applicable population, treatment methods, application status, and the efficacy of vaginal cone in the treatment of SUI.

Key words: Vaginal cone, Urinary incontinence, stress, Pelvic floor muscle rehabilitation, Conservative treatment

石金明, 张颐. 阴道哑铃治疗女性压力性尿失禁的研究进展[J]. 国际妇产科学杂志, 2021, 48(2): 208-212.

SHI Jin-ming, ZHANG Yi. Research Progress of Vaginal Cone in Treatment of Female Stress Urinary Incontinence[J]. Journal of International Obstetrics and Gynecology, 2021, 48(2): 208-212.

图/表 3

参考文献 24

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研究对象	样本量	有效性评价方法	试验结果	参考文献
SUI妇女	41（阴道哑铃3个月,n=21;TOT,n=20）	瓦格纳生活质量问卷和咳嗽压力试验	TOT是SUI的主要疗法是对于拒绝手术或有高手术风险的妇女,阴道哑铃可作替代疗法提供,或在手术前暂时使用	[8]
绝经后SUI妇女	32（HRT+阴道哑铃,n=22;HRT,n=10）	会阴肌力测试,尿垫试验,3 d尿失禁次数	阴道哑铃增加了盆底肌肉强度,增加患者进行盆底肌恢复训练的热情	[17]
SUI妇女	86（阴道哑铃,n=43;生物反馈,n=43）	会阴肌力测试,患者反馈	生物反馈组疗效更好	[20]
妊娠SUI妇女	200（凯格尔运动,n=100;阴道哑铃+生物反馈,n=100）	肌纤维强度,肌纤维疲劳度	阴道哑铃联合生物反馈组比单纯凯格尔运动疗效更好	[24]
产后SUI妇女	120（生物反馈,n=60;生物反馈+阴道哑铃,n=60）	肌纤维强度,尿失禁次数	阴道哑铃联合生物反馈组比单纯生物反馈疗效更好	[21]
产后SUI妇女	60（凯格尔运动,n=30;凯格尔运动+阴道哑铃,n=30）	肌纤维强度	对Ⅰ型肌纤维阴道哑铃联合凯格尔运动疗效好于单纯凯格尔运动	[10]

研究对象	样本量	有效性评价方法	试验结果	参考文献
SUI妇女	41（阴道哑铃3个月,n=21;TOT,n=20）	瓦格纳生活质量问卷和咳嗽压力试验	TOT是SUI的主要疗法是对于拒绝手术或有高手术风险的妇女,阴道哑铃可作替代疗法提供,或在手术前暂时使用	[8]
绝经后SUI妇女	32（HRT+阴道哑铃,n=22;HRT,n=10）	会阴肌力测试,尿垫试验,3 d尿失禁次数	阴道哑铃增加了盆底肌肉强度,增加患者进行盆底肌恢复训练的热情	[17]
SUI妇女	86（阴道哑铃,n=43;生物反馈,n=43）	会阴肌力测试,患者反馈	生物反馈组疗效更好	[20]
妊娠SUI妇女	200（凯格尔运动,n=100;阴道哑铃+生物反馈,n=100）	肌纤维强度,肌纤维疲劳度	阴道哑铃联合生物反馈组比单纯凯格尔运动疗效更好	[24]
产后SUI妇女	120（生物反馈,n=60;生物反馈+阴道哑铃,n=60）	肌纤维强度,尿失禁次数	阴道哑铃联合生物反馈组比单纯生物反馈疗效更好	[21]
产后SUI妇女	60（凯格尔运动,n=30;凯格尔运动+阴道哑铃,n=30）	肌纤维强度	对Ⅰ型肌纤维阴道哑铃联合凯格尔运动疗效好于单纯凯格尔运动	[10]