针刺配合盆底肌锻炼治疗急性脑梗死后强制性尿失禁59例临床观察

摘要

目的：观察针刺配合盆底肌锻炼治疗急性脑梗死后强制性尿失禁的临床疗效。方法将118例急性脑梗死后强制性尿失禁患者随机分为2组。对照组59例实施盆底肌锻炼，治疗组59例在对照组基础上实施针刺，疗程30 d。比较2组患者逼尿肌与尿道外括约肌异常情况、膀胱指征的改变情况、治疗效果及尿路感染情况。结果治疗组治疗后逼尿肌与尿道外括约肌异常改善情况明显优于对照组（ P＜0．05）。2组治疗后患者膀胱最大容积、膀胱最大收缩压、膀胱充盈初始量及尿道闭合压均明显改善（P＜0．05），且治疗组改善情况优于对照组（ P＜0．05）。治疗组愈显率89．83％、总有效率98．31％，对照组分别为61．02％、88．14％，2组愈显率及总有效率比较差异有统计学意义（P＜0．05）。治疗组尿路感染发生率3．39％，明显低于对照组（13．56％，P＜0．05）。结论针刺配合盆底肌锻炼治疗急性脑梗死后强制性尿失禁安全有效，可明显改善临床症状，显著提高治愈率，减少尿路感染。%Objective To investigate the effects of acupuncture combined with pelvic floor muscle exercises on mandatory urinary incontinence after acute cerebral infarction.Methods 118 patients with mandatory urinary in-continence after acute cerebral infarction were randomly divided into two groups,59 patients in control group were treated by pelvic floor muscle exercises,59 patients in treatment group were treated by acupuncture on the basis of control group treatment.The course was 30 days in two groups.Abnormal conditions of detrusor muscle and external u-rethral sphincter, changes of bladder indications, clinical effects and urinary tract infections in two groups were com-pared.Results Abnormal conditions of detrusor muscle and external urethral sphincter in treatment group after treat-ment were obviously improved as compared with those in control group (P<0.05).The maximum bladder capacity, maximum bladder systolic pressure, initial amount of bladder filling and urethra closure pressure after treatment were obviously improved in two groups (P<0.05), and the improvement in treatment group were superior to those in con-trol group (P<0.05).The markedly effective rate and total effective rate in treatment group (89.83%, 98.31%) were superior to those in control group (61.02%, 88.14%).The incidence rate of urinary tract infections in treat-ment group (3.39%) was obviously lower than that in control group (13.56%, P<0.05).Conclusion The com-bined therapy of acupuncture and pelvic floor muscle exercises is effective and safe in the treatment of mandatory uri-nary incontinence after acute cerebral infarction, can significantly improve clinical symptom and cure rate, decrease the incidence of urinary tract infection.