探讨阴道哑铃训练联合盆底肌生物反馈治疗老年女性压力性尿失禁的疗效。

选取2018年10月至2020年4月甘肃省康复中心医院收治的老年女性压力性尿失禁患者78例，其中39例（对照组）给予常规盆底肌训练，余39例（联合组）在对照组的基础上给予阴道哑铃训练联合盆底肌生物反馈治疗。比较两组患者治疗前后的盆底肌收缩能力、尿动力学状况以及临床疗效和生活质量。计量资料的组间比较采用t检验，计数资料的比较采用χ²检验。

联合组总有效率明显高于对照组（87.17%、51.28%；χ²=11.796，P<0.05）。两组患者治疗后的I-QOL评分均较治疗前明显提高（t=23.516、12.164，P<0.05），治疗后两组患者I-QOL评分的差异有统计学意义（t=8.790，P<0.05）。治疗后联合组患者慢肌/快肌纤维肌力均明显高于对照组，慢肌/快肌纤维肌疲劳度均明显低于对照组，差异有统计学意义（肌力：t=17.711、11.988，疲劳度：t=31.549、26.113；P<0.05）。治疗后联合组患者最大尿意膀胱最大容量、膀胱顺应性、尿道最大闭合压力、尿道最大测量压、腹压漏尿点压、功能尿道长度均明显高于对照组（t=2.362、2.331、2.573、2.999、2.777、2.806，P<0.05）。

阴道哑铃训练联合盆底肌生物反馈治疗老年女性压力性尿失禁疗效明显，能够提高盆底肌收缩能力并改善控尿，改善患者生活质量。

To investigate the efficacy of vaginal dumbbell training combined with pelvic floor muscle biofeedback in the treatment of stress urinary incontinence in elderly women.

A total of 78 elderly female patients with stress urinary incontinence admitted to gansu Rehabilitation Center Hospital from October 2018 to April 2020 were selected. Among them, 39 patients were given routine pelvic floor muscle training (control group), and the remaining 39 were given vaginal dumbbell training combined with pelvic floor muscle biofeedback therapy (combined group) on the basis of control group. The pelvic floor muscle contractility, urodynamic status, clinical efficacy and quality of life of two groups were compared before and after treatment. T test was used for comparison of measurement data between groups, and χ² test was used for comparison of count data.

The total effective rate of combined group was significantly higher than that of control group (87.17%, 51.28%; χ²=11.796, P < 0.05). The I-QOL scores of the two groups after treatment were significantly higher than those before treatment (t=23.516, 12.164, P < 0.05), and the difference of I-QOL score between two groups after treatment was statistically significant (t=8.790, P < 0.05). After treatment, the muscle strength of slow muscle/fast muscle fiber in the combined group was significantly higher than that in the control group (t=17.711, 11.988; P < 0.05), and the fatigue degree of slow muscle/fast muscle fiber was significantly lower than that in the control group, with statistical significance (t=31.549, 26.113; P < 0.05). After treatment, the maximum urinary bladder volume, bladder compliance, maximum urethral closure pressure, maximum measured urethral pressure, abdominal pressure leak point pressure and functional urethral length in the combined group were significantly higher than those in the control group (t=2.362, 2.331, 2.573, 2.999, 2.777, 2.806; P < 0.05).

Vaginal dumbbell training combined with pelvic floor muscle biofeedback has obvious efficacy in the treatment of elderly women with stress urinary incontinence, which can improve pelvic floor muscle contraction ability and urine control, thus improving patients' quality of life.