点阵CO<sub>2</sub>激光治疗女性轻中度压力性尿失禁的临床疗效分析

doi:10.3877/cma.j.issn.1674-3253.2022.01.009

目的

探究经阴道点阵CO₂激光治疗女性轻、中度压力性尿失禁（SUI）的临床疗效。

方法

回顾性研究本院2017年1月至2020年12月收治的轻中度SUI女性患者。激光治疗组41例，进行点阵CO₂激光联合盆底肌训练治疗，每月治疗1次，共治疗3次；生物反馈治疗组20例，采用生物反馈电刺激联合盆底肌训练。比较两组患者治疗后临床疗效、国际尿失禁委员会尿失禁问卷简表（ICI-Q-SF）、尿失禁生活质量问卷（I-QOL）及女性性功能量表（FSFI）评分。

结果

治疗后，激光治疗组总有效率为92.68%，疗效强于生物反馈组（P<0.05）；治疗后ICI-Q-SF、I-QOL、FSFI评分均得到改善（P<0.01）；与生物反馈治疗组比较，激光治疗组I-QOL、FSFI增加更显著（P<0.05），ICI-Q-SF评分明显降低（P<0.01）。3例患者治疗时述阴道烧灼感，休息后好转，5例患者出现一过性的尿急，部分患者阴道分泌物增多后自行恢复，整个治疗过程无其他不良事件发生。

结论

点阵CO₂激光治疗能够有效改善轻、中度SUI患者的临床症状，提高患者性功能和生活质量，具有良好临床疗效。

关键词: 压力性尿失禁, 二氧化碳激光, 电刺激, 盆底肌训练

Objective

To explore the clinical efficacy of transvaginal fractional CO₂ laser in the treatment of female with mild-to-moderate stress urinary incontinence (SUI).

Methods

A retrospective study of female patients with mild-to-moderate SUI admitted to our hospital from January 2017 to December 2020. 41 cases received fractional CO₂ laser treatment once a month for 3 times (Group A). Meanwhile, 20 cases received biofeedback electrostimulation (Group B). Both groups were combined with pelvic floor muscle training. The clinical efficacy, International Consultation on Incontinence Questionnaire-short Form (ICI-Q-SF), Quality of Life Questionnaire (I-QOL) and Female Sexual Function Inventory (FSFI) scores were compared between the two groups after treatment.

Results

After treatment, the total effective rate of Group A was 92.68%, which was higher than that in Group B (P<0.05); the scores of ICI-Q-SF, I-QOL and FSFI improved after treatment (P<0.01) in Group A; Compared with Group B, the I-QOL and FSFI in Group A increased significantly (P<0.05), and the ICI-Q-SF score was significantly reduced (P<0.01). Three patients reported vaginal burning sensation during treatment, which relieved after rest, five patients showed transient urgency of urination, and some patients recovered spontaneously after increased vaginal secretion. No other adverse events occurred during the study.

Conclusion

The fractional CO₂ laser was found to be effective for mild-to-moderate SUI, according to a variety of objective and subjective parameters, which can effectively improve the clinical symptoms, the sexual function and quality of life of patients.

Key words: Stress urinary incontinence, Carbon dioxide laser, Electrostimulalion, Pelvic floor muscle training

表1 两组女性轻中度压力性尿失禁患者治疗前一般资料的比较

组别	例数	年龄[岁，(±s)]	分娩胎数[胎，(±s)]	1 h尿垫试验漏尿量[g，(±s)]	VLPP[cmH₂O，(±s)]	功能尿道长度[cm，(±s)]	最大尿道闭合压[cmH₂O，(±s)]	绝经人数[例(%)]	剖宫产人数[例(%)]
CO₂激光治疗组	41	47±10	1.76±0.82	3.96±2.23	94.34±26.92	2.74±0.66	66.68±27.34	14(34.15)	7(17.07)
生物反馈治疗组	20	48±10	1.85±0.75	4.82±2.52	93.85±26.76	2.66±0.63	64.35±23.98	8(40.00)	5(25.00)
P值		0.676	0.694	0.183	0.939	0.683	0.661	0.655	0.342

表1 两组女性轻中度压力性尿失禁患者治疗前一般资料的比较

组别	例数	年龄[岁，(±s)]	分娩胎数[胎，(±s)]	1 h尿垫试验漏尿量[g，(±s)]	VLPP[cmH₂O，(±s)]	功能尿道长度[cm，(±s)]	最大尿道闭合压[cmH₂O，(±s)]	绝经人数[例(%)]	剖宫产人数[例(%)]
CO₂激光治疗组	41	47±10	1.76±0.82	3.96±2.23	94.34±26.92	2.74±0.66	66.68±27.34	14(34.15)	7(17.07)
生物反馈治疗组	20	48±10	1.85±0.75	4.82±2.52	93.85±26.76	2.66±0.63	64.35±23.98	8(40.00)	5(25.00)
P值		0.676	0.694	0.183	0.939	0.683	0.661	0.655	0.342

表2 两组患者治疗前、后各项评分的比较[分，±s]

组别	例数	时间	ICI-Q-SF	I-QOL	FSFI
CO₂激光治疗组	41	治疗前	8±4	79±20	24±4
CO₂激光治疗组	41	治疗后	6±4^bd	88±14^bc	27±3^bc
生物反馈治疗组	20	治疗前	8±3	78±16	24±5
生物反馈治疗组	20	治疗后	7±4^a	81±15^a	25±5

表2 两组患者治疗前、后各项评分的比较[分，±s]

组别	例数	时间	ICI-Q-SF	I-QOL	FSFI
CO₂激光治疗组	41	治疗前	8±4	79±20	24±4
CO₂激光治疗组	41	治疗后	6±4^bd	88±14^bc	27±3^bc
生物反馈治疗组	20	治疗前	8±3	78±16	24±5
生物反馈治疗组	20	治疗后	7±4^a	81±15^a	25±5

表3 两组患者治疗后临床疗效比较（例）

组别	例数	痊愈	显效	有效	无效	总有效率
CO₂激光治疗组	41	4	16	18	3	92.68%
生物反馈治疗组	20	1	5	8	6	70.00%

表3 两组患者治疗后临床疗效比较（例）

组别	例数	痊愈	显效	有效	无效	总有效率
CO₂激光治疗组	41	4	16	18	3	92.68%
生物反馈治疗组	20	1	5	8	6	70.00%

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Clinical efficacy analysis of fractional CO₂ laser in the treatment of female with mild-to-moderate stress urinary incontinence

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Clinical efficacy analysis of fractional CO2 laser in the treatment of female with mild-to-moderate stress urinary incontinence

Clinical efficacy analysis of fractional CO₂ laser in the treatment of female with mild-to-moderate stress urinary incontinence