产后压力性尿失禁康复管理的最佳证据总结

doi:10.3761/j.issn.1672-9234.2024.02.016

Abstract

Abstract:

Objective To summarize the evidence related to rehabilitative care for patients with postpartum stress urinary incontinence. Methods Computerized search was conducted for clinical decisions，guidelines，expert consensus，evidence summaries and systematic reviews related to rehabilitation of postpartum stress urinary incontinence in the BMJ，UpToDate，related guideline or association websites，PubMed，Cochrane Library，Embase，Web of Science，CNKI，Wanfang Data，VIP，and China Biomedical Literature Service System. The retrieval time was from the database establishment to July 2023. Researchers independently screened literature，extracted data，and evaluated the quality of the included literature. The evidence was extracted from the included literatures，and the best evidence was summarized，then its quality was graded. Results A total of ten articles were included，including one guideline，two clinical decisions，five systematic review，and two evidence summaries，resulting in 17 pieces of best evidence in three areas：assessment of postpartum stress urinary incontinence，rehabilitation therapy and health education. Conclusion This study summarizes the best evidence for rehabilitative management of postpartum stress urinary incontinence and provides healthcare professionals with guidance for rehabilitative management of patients with postpartum stress urinary incontinence.

Key words: Postpartum, Stress urinary incontinence, Rehabilitation management, Evidence-based nursing

LI Mengjie, GOU Xiaoyu, LU Nan, CHI Jiajing, YU Wanhui, YANG Lijuan. Summary of the best evidence for rehabilitative management of postpartum stress urinary incontinence[J].Chinese Journal of Nursing Education, 2024, 21(2): 224-230.

Figures/Tables 2

References 36

[1]	Liang CC, Chang SD, Lin SJ, et al. Lower urinary tract sym-ptoms in primiparous women before and during pregnancy[J]. Arch Gynecol Obstet, 2012, 285(5):1205-1210. doi: 10.1007/s00404-011-2124-2
[2]	Solans-Domènech M, Sánchez E, Espuña-Pons M. Urinary and anal incontinence during pregnancy and postpartum[J]. Obstet Gynecol, 2010, 115(3):618-628. doi: 10.1097/AOG.0b013e3181d04dff pmid: 20177295
[3]	Qi XW, Shan J, Peng L, et al. The effect of a comprehensive care and rehabilitation program on enhancing pelvic floor muscle functions and preventing postpartum stress urinary incontinence[J]. Medicine, 2019, 98(35):e16907. doi: 10.1097/MD.0000000000016907
[4]	周玉洁, 支慧. 产后尿失禁病人心理体验定性研究的Meta整合[J]. 全科护理, 2022, 20(32):4484-4488.
	Zhou YJ, Zhi H. Psychological experience in postpartum pa-tients with urinary incontinence:a qualitative meta-synthesis[J]. Chin Gen Pract Nurs, 2022, 20(32):4484-4488.
[5]	葛君, 冶海红, 蒲巍林, 等. 研究康复训练联合生物反馈及电刺激在产后压力性尿失禁中的应用效果[J]. 中国妇产科临床杂志, 2019, 20(1):59-60.
[6]	王雪格. 自我管理干预在女性压力性尿失禁患者盆底肌锻炼中的应用[D]. 郑州: 郑州大学, 2017.
	Wang XG. Study on effects of self-management intervention on pelvic floor muscle training of female patients with stress urinary incontinence[D]. Zhengzhou: Zhengzhou University, 2017.
[7]	范国荣, 薄海欣. 达标理论在产后尿失禁患者盆底康复训练中的应用研究[J]. 中华护理杂志, 2019, 54(4):506-510. doi: 10.3761/j.issn.0254-1769.2019.04.005
	Fan GR, Bo HX. Application of theory of goal attainment in pelvic floor rehabilitation for patients with postpartum urinary incontinence[J]. Chin J Nurs, 2019, 54(4):506-510. doi: 10.3761/j.issn.0254-1769.2019.04.005
[8]	陈洁, 范国荣, 薄海欣. 产后压力性尿失禁患者盆底肌训练现状及应对策略的研究进展[J]. 中国护理管理, 2021, 21(4):608-612.
[9]	周芬, 郝玉芳, 丛雪, 等. 指南研究与评价工具AGREE Ⅱ及各领域分值的补充解释及思考[J]. 护理学报, 2018, 25(18):56-58.
[10]	The Joanna Briggs Institute. Checklist for systematic reviews and research syntheses[EB/OL].[2023-07-25]. http://joannabri-ggs.org/research/critical-ap-praisal-tools.html.
[11]	Foster MJ, Shurtz S. Making the Critical Appraisal for Sum-maries of Evidence(CASE) for evidence-based medicine(EBM):critical appraisal of summaries of evidence[J]. J Med Libr Assoc, 2013, 101(3):192-198. doi: 10.3163/1536-5050.101.3.008
[12]	王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967.
	Wang CQ, Hu Y. JBI evidence pre-classification and evidence rank system(2014 Edition)[J]. J Nurses Train, 2015, 30(11):964-967.
[13]	胡雁, 郝玉芳. 循证护理学[M]. 2版. 北京: 人民卫生出版社, 2018.
	Hu Y, Hao YF, Evidence-based nursing[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2018.
[14]	Victoria LH. Effect of pregnancy and childbirth on urinary incontinence and pelvic organ prolapse[EB/OL].[2023-07-25]. http://www.update.com/contents/effect-of-pregnancy-and-childbir-th-on-urinary-incontinence-and-pelvic-organ-prolapse.
[15]	Raul A. Exercise during pregnancy and the postpartum period[EB/OL].[2023-07-25]. https://www.uptodate.com/contents/exer-cise-during-pregnancy-and-the-postpartum-period.
[16]	中华预防医学会妇女保健分会. 产后保健服务指南[J]. 中国妇幼健康研究, 2021, 32(6):767-781.
	Branch of Women’s Health Care,Chinese Prevention Medicine Association. Guideline to postpartum health services[J]. Chin J Woman Child Health Res, 2021, 32(6):767-781.
[17]	Diz-Teixeira P, Alonso-Calvete A, Justo-Cousiño LA, et al. Up-date on physiotherapy in postpartum urinary incontinence. A systematic review[J]. Arch Esp Urol, 2023, 76(1):29-39. doi: 10.56434/j.arch.esp.urol.20237601.2
[18]	蓝敏艳, 李森, 王雪宁, 等. 非手术干预方案改善产后盆底功能障碍有效性的网状Meta分析[J]. 护理研究, 2023, 37(9):1568-1580.
	Lan MY, Li S, Wang XN, et al. Efficacy of non-surgical inter-ventions in improving postpartum pelvic floor dysfunction:a network Meta-analysis[J]. Chin Nurs Res, 2023, 37(9):1568-1580.
[19]	Yang XW, Zhang AX, Sayer L, et al. The effectiveness of group-based pelvic floor muscle training in preventing and treating urinary incontinence for antenatal and postnatal women:a systematic review[J]. Int Urogynecology J, 2022, 33(6):1407-1420. doi: 10.1007/s00192-021-04960-2
[20]	张晨, 骆睿翔, 息金波, 等. 针灸联合盆底肌训练治疗产后压力性尿失禁Meta分析[J]. 实用中医内科杂志, 2022, 36(11):72-75.
	Zhang C, Luo RX, Xi JB, et al. Acupuncture combined with pelvic floor muscle training in the treatment of postpartum stress urinary incontinence:a meta analysis[J]. J Pract Tradit Chin Intern Med, 2022, 36(11):72-75.
[21]	季佳, 陈锦霞, 杜楠楠, 等. 盆底肌锻炼联合生物反馈电刺激对产后女性盆底肌康复影响的Meta分析[J]. 中外医学研究, 2020, 18(13):1-5.
	Ji J, Chen JX, Du NN, et al. Meta analysis on effect of pelvic floor muscle exercise by biofeedback and electrical stimu-lation to improve maternal pelvic floor rehabilitation[J]. Chin Foreign Med Res, 2020, 18(13):1-5.
[22]	王彤, 彭玉娜, 郭路. 盆底肌训练防治孕产妇尿失禁的最佳证据总结[J]. 重庆医学, 2023, 52(20):3159-3165.
	Wang T, Peng YN, Guo L. Summary of the best evidence for pelvic floor muscle training in preventing and treating urinary incontinence in maternal[J]. Chongqing Med, 2023, 52(20):3159-3165.
[23]	de Viñaspre RR, Elena Garrido A, Alvarez MA. Training wo-men’s pelvic floor muscles during pregnancy and postpartum at primary health centers:a best practice implementation project[J]. JBI Evid Implement, 2021, 19(3):245-256. doi: 10.1097/XEB.0000000000000288 pmid: 34224524
[24]	中华医学会妇产科学分会妇科盆底学组. 女性压力性尿失禁诊断和治疗指南(2017)[J]. 中华妇产科杂志, 2017, 52(5):289-293.
	Urogynocology Subgroup,Chinese Society of Obstetrics and Gynocology,Chinese Medical Association. Update of guideline on the diagnosis and treatment of female stress urinary in-continence(2017)[J]. Chin J Obstet Gynecol, 2017, 52(5):289-293.
[25]	Suar G, Cevik F, Simal Yavuz N, et al. Urinary incontinence in the postpartum 1-year period:its prevalence and effect on psychosocial status of women[J]. Low Urin Tract Symptoms, 2023, 15(5):191-199.
[26]	谷瑞芮. 产后压力性尿失禁妇女盆底肌训练依从性及影响因素研究[D]. 北京: 北京协和医学院, 2020.
	Gu RR. Investigation on pelvic floor muscle training adheren-ce and influencing factors in postpartum stress urinary incon-tinence women[D]. Beijing: Peking Union Medical College, 2020.
[27]	Sacomori C, Berghmans B, Mesters I, et al. Strategies to enhan-ce self-efficacy and adherence to home-based pelvic floor muscle exercises did not improve adherence in women with urinary incontinence:a randomised trial[J]. J Physiother, 2015, 61(4):190-198. doi: 10.1016/j.jphys.2015.08.005 pmid: 26365268
[28]	Radzimińska A, Strᶏczyńska A, Weber-Rajek M, et al. The im-pact of pelvic floor muscle training on the quality of life of women with urinary incontinence:a systematic literature review[J]. Clin Interv Aging, 2018, 13:957-965. doi: 10.2147/CIA.S160057 pmid: 29844662
[29]	Wu TF, Huang LH, Lai YF, et al. Early postpartum biofeed-back assisted pelvic floor muscle training in primiparous women with second degree perineal laceration:effect on sexual function and lower urinary tract symptoms[J]. Taiwan J Obstet Gynecol, 2021, 60(1):78-83. doi: 10.1016/j.tjog.2020.11.011
[30]	Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment,or inactive control treatments,for urinary incontinence in women[J]. Cochrane Database Syst Rev, 2018, 10(10):CD005654.
[31]	Wang XJ, Xu XF, Luo JM, et al. Effect of app-based audio guidance pelvic floor muscle training on treatment of stress urinary incontinence in primiparas:a randomized controlled trial[J]. Int J Nurs Stud, 2020, 104:103527. doi: 10.1016/j.ijnurstu.2020.103527
[32]	Brennen R, Frawley HC, Martin J, et al. Group-based pelvic floor muscle training for all women during pregnancy is more cost-effective than postnatal training for women with urinary incontinence:cost-effectiveness analysis of a systematic review[J]. J Physiother, 2021, 67(2):105-114. doi: 10.1016/j.jphys.2021.03.001
[33]	Papanikolaou DT, Lampropoulou S, Giannitsas K, et al. Pelvic floor muscle training:novel versus traditional remote reha-bilitation methods. A systematic review and meta-analysis on their effectiveness for women with urinary incontinence[J]. Neurourol Urodyn, 2023, 42(4):856-874. doi: 10.1002/nau.v42.4
[34]	Liu DC, Gao L, Liu Y, et al. Effect of different interventions on the efficacy of postpartum urinary incontinence in China:a systematic review and network meta-analysis[J]. Medicine, 2023, 102(40):e35473. doi: 10.1097/MD.0000000000035473
[35]	汪婕, 张银雪, 任旭. 格林健康教育联合凯格尔盆底康复训练对产妇产后盆底功能及预后的影响[J]. 护理研究, 2022, 36(6):1110-1113.
	Wang J, Zhang YX, Ren X. Effects of Green health education combined with Kegel pelvic floor rehabilitation training on postpartum pelvic floor function and prognosis of maternity[J]. Chin Nurs Res, 2022, 36(6):1110-1113.
[36]	丁子钰. 回授法在女性压力性尿失禁患者盆底肌锻炼中的应用[D]. 郑州: 郑州大学, 2022.
	Ding ZY. Application of teach-back method in pelvic floor muscle exercise of female patients with stress urinary incontinence[D]. Zhengzhou: Zhengzhou University, 2022.

Summary of the best evidence for rehabilitative management of postpartum stress urinary incontinence

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