社区综合干预辅助治疗女性轻中度压力性尿失禁患者的临床疗效

摘要

目的 分析社区综合干预辅助治疗女性轻中度压力性尿失禁患者的临床疗效.方法 2016年4—12月在北京市丰台区方庄社区卫生服务中心张贴海报招募到女性轻中度压力性尿失禁患者60例,按照先后顺序分为社区组和医院组,每组30例.医院组患者在北京协和医院妇产科门诊接受生物反馈联合电刺激治疗,社区组患者在北京市丰台区方庄社区卫生服务中心接受生物反馈联合电刺激治疗并辅以社区综合干预,两组患者均干预并随访12周.比较两组患者干预前及干预后8周、12周1 h尿垫试验漏尿量和尿失禁生活质量量表(I-QOL)评分.结果 随访期间,医院组患者失访11例,社区组患者无一例失访;社区组患者失访率低于医院组(P<0.05).时间与方法在1 h尿垫试验漏尿量和I-QOL评分上存在交互作用(P<0.05);时间与方法在1 h尿垫试验漏尿量和I-QOL评分上主效应显著(P<0.05).干预后8周、12周社区组患者1 h尿垫试验漏尿量少于医院组,I-QOL评分高于医院组(P<0.05).结论 在生物反馈联合电刺激治疗基础上辅以社区综合干预能有效提高女性轻中度压力性尿失禁患者治疗依从性及生活质量,减少漏尿量.%Objective To analyze the clinical effect of comprehensive community intervention in the adjuvant therapy for women with mild to moderate stress urinary incontinence.Methods From April to December in 2016,a total of 60 women with mild to moderate stress urinary incontinence were recruited by putting up posters in Fangzhuang Community Health Service Center,Fengtai District,Beijing,and they were divided into community group and hospital group according to the recruitment order,each of 30 cases. Women in hospital group received biofeedback combined with electrical stimulation treatment in Gynecology and Obstetrics Clinic,Peking Union Medical College Hospital,while women in community group received comprehensive community intervention(as adjuvant therapy)based on biofeedback combined with electrical stimulation treatment in Fangzhuang Community Health Service Center,Fengtai District,Beijing;both groups continuously intervened and followed up for 12 weeks.Leakage volume of 1-hour urinal pad test and Incontinence Quality of Life Scale(I-QOL) score before intervention,8 and 12 weeks after intervention were compared between the two groups.Results During follow-up,11 cases in hospital group lost,while no one in community group lost;lost rate of follow-up in community group was statistically significantly lower than that in hospital group(P<0.05). There was significant interaction between time and method in leakage volume of 1-hour urinal pad test and I-QOL score(P<0.05);main effects of time and method were significant in leakage volume of 1-hour urinal pad test and I-QOL score(P<0.05). After 8 and 12 weeks of intervention,leakage volume of 1-hour urinal pad test in community group was statistically significantly less than that in hospital group,respectively,while I-QOL score in community group was statistically significantly higher than that in hospital group,respectively(P<0.05).Conclusion  Based on biofeedback combined with electrical stimulation treatment,comprehensive community intervention(as adjuvant therapy)can effectively improve the treatment compliance and quality of life,reduce the urinal leakage volume in women with mild to moderate stress urinary incontinence.