骨盆底肌肉運動對攝護腺根除術後病患尿失禁改善成效之研究

本研究目的在探討攝護腺根除術後病患執行骨盆底肌肉運動3個月後，是否能改善病患的尿失禁、加強其骨盆底肌肉強度與提升其活品質。採類實驗性研究設計，以隨機取樣方式分成實驗組與對照組，以接受根除性攝護腺切除術後病患57人，實驗組共32位病患，於居家期間給予骨盆底肌肉運動訓練為介入措施，對照組有25位則未給予此運動運動訓練僅依照目前的照護模式。研究工具採用：攝護腺切除術後排尿評量表，1小時漏尿試驗、24小時尿墊使用數量，肛門壓力測量，生活品質量表（UCLA-PCI）及個人基本資料與疾病特性等六項問卷為測量工具。研究結果：在追蹤至術後三個月，由重複測量雙因子共變數分析發現，雖然實驗組與對照組病患的尿失禁情形隨著手術後時間的增加都有逐漸改善，然實驗組的排尿評量得分與1小時漏尿量在控制了攝護腺重量後，其改善程度後均顯著優於對照組。此外，在24小時尿墊使用數量、骨盆底肌肉強度和生活品質三個變項方面，實驗組與對照組病患隨著術後時間的增加均有顯著的改善情形，但實驗組與對照組間均沒有達到顯著差異。結論：骨盆底運動介入6-8週後能顯著改善攝護腺根除術後病患的尿失禁，但對於骨盆底肌肉強度與生活品質則沒有顯著成效。

關鍵字

骨盆底運動；生活品質；根除性攝護腺切除；尿失禁

並列摘要

Urinary incontinence is one of the major problems in patients who were received radical prostatectomy. The purpose of this study was to compare the effectiveness of the pelvic floor muscle exercise in urinary incontinence following prostatectomy. The quasi-experimental design was used. Instruments included six parts: urination questionnaire of prostatectomy, one hour pad test, the amount of pad used during 24 hours, anal pressure manometry, University of California in Los Angel Prostate Cancer Index (UCLA-PCI), demographic and disease characteristics. A total of 57 patients were included in the study, and randomized to an exercise group (n = 32) vs a control group (n = 25). In exercise group taught the pelvic floor muscle exercise plus biofeedback by researchers began after urinary catheter removal. Results: The results indicate that after three months, by two-way ANCOVA with repeated measures found that after control the weight of prostate, the scores of urination and leakage weight of one hour pad test were significant improvement in exercise group when compared to control group. There were no significant differences found between two group in 24 hrs amount of pad used, pelvic muscle strength and scores of UCLA-PCI. Conclusion: This study demonstrated that pelvic floor muscle exercises could significant improve urinary incontinence of prostatectomy recipients, but did not have this effects on pelvic muscle strength and quality of life.