治疗产后尿失禁的培训干预措施的影响:元分析
Cristina Gallego-Gómez1,2,3, Sergio Núñez de Arenas-Arroyo3, Ana Torres-Costoso1,3
1Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain.
BJOG : an international journal of obstetrics and gynaecology
|September 25, 2025
概括
盆地肌肉训练 (PFMT) 有效地减少产后尿失禁 (UI). 将PFMT与电刺激,生物反或腹肌训练相结合,也可以显著改善产后妇女的UI症状.
科学领域:
- 康复医学 康复医学 康复医学
- 妇科 妇科 妇科 妇科
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 产后尿失禁 (UI) 是一种普遍的疾病,影响许多妇女分娩后.
- 目前的建议强调为管理产后UI的培训干预措施.
- 各种保守方法的有效性需要全面评估.
研究的目的:
- 系统地评估盆地肌肉训练 (PFMT) 单独或与其他保守方法相结合对产后UI的影响.
- 综合实验性研究对产后期UI严重性培训干预措施的证据.
主要方法:
- 在主要数据库 (MEDLINE,Scopus,Cochrane Library,Web of Science,PEDro) 进行了系统的文献搜索,截至2024年11月.
- 在由三位研究人员进行独立审查后,包括了19项实验研究.
- 哈顿-克纳普-西迪克-乔克曼方法用于元分析,计算标准化平均差异 (SMD) 和95%置信区间 (CI).
主要成果:
- 在将一般培训干预措施与对照组或单独教育进行比较时,没有发现UI严重性的显著差异.
- 预后分析显示,使用PFMT (SMD = -1.45),使用电刺激 (ES) /生物反 (BFB) 的PFMT (SMD = -2.16),以及与腹肌训练 (AMT) 结合的PFMT (SMD = -1.73) 的UI严重性显著降低.
- 这些特定的培训模式表明,产后妇女的UI症状在统计学上有显著的改善.
结论:
- 无论单独使用还是与ES,BFB或AMT一起使用,PFMT都代表了产后UI的可行的保守治疗策略.
- 这些发现支持使用这些联合培训方法来管理产后期的UI.
- 需要进一步的研究,以确定腹壁训练作为UI的独立治疗方法的具体建议.
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