尿失禁婦女骨盆底肌肉運動介入之成效及其相關因素探討

本研究目的在探討尿失禁婦女經由骨盆底肌肉運動之效果及其相關因素。採類實驗性研究設計，樣本取自中部某醫學中心婦女尿失禁門診之病患，年齡在55歲（含）以下者，共計70人。研究樣本接受每週一次，每次2小時，為期12週的骨盆底肌肉運動訓練。在介入前、後均以結構式問卷訪談收集資料，資料以SAS for windows 6.11 version套裝軟體進行統計，分析方法有描述性統計（百分比、平均值、標準差）及推論性統計（t-test）。研究結果顯示：尿失禁婦女經骨盆底肌肉運動介入後，1.尿失禁嚴重程度治癒者佔28.57%、改善者佔17.15%；2.在尿失禁之各項症狀及生活品質亦均有改善；3.以陰道壓力計測量陰道緊縮情形，骨盆底肌肉運動確實可增加陰道肌肉強度。至於其影響因素，在症狀改善方面為生產次數、曾藥物治療及遵從行為；在生活品質方面為年齡、曾主動求治者、曾接受檢查者、曾藥物治療者、希望藉運動改善者及遵從行為等；而影響陰道壓力緊縮情形者為教育程度及遵從行為等，且均具統計上差異（p<0.05至p<0.001）。亦即年齡較輕、教育程度高、就醫意願較高及遵從行為較好者，是改善的主要影響因素。因此，建議女性在第一胎生產後，即指導其執行骨盆底肌肉運動，以預防尿失禁之發生，而已發生尿失禁之婦女更應開班指導，以提昇生活品質，並防止尿失禁導致之醫療成本浪費。

The purpose of the study was to discuss the efficacy and relative factors of pelvic floor muscle exercise in incontinent women. The design of Quasi- experiment research, samples of incontinent women were collected in medical center in Mid-Taiwan. There were 70 patients under age 55-year old. They received a training of pelvic floor muscle exercise 2 hours each time, once a week for 12 - weeks. The constructive questionnaire were used to collect information before and after they volunteer the exercise . Data was analyzed by soft ward of SAS for windows 6.11 version. The methods of statistics were descriptive statistics (percentage, mean, standard deviation) and t-test. The result appeared：1.Serious degree therapy was 28.57% and improvement was 17.15% .; 2.All symptoms and life quality after pelvic floor muscle exercise were improved . ；3.Through the test of vaginal manometry , pelvic floor muscle exercise can enhance the strength of vaginal muscle .The affected factors in improved symptoms were the numbers of delivery、had medication treatment、 and compliance; in quality of life were age、sought for medical assistance、had medical examination、had medication treatment、had motive to improve symptom by exercise and compliance; in affected strength of vaginal muscle were education background and compliance. All factors were statically significant(p<0.05 to p<0.001).In another word, The major affected were younger age、higher education background 、higher motive to visit Doctor and higher compliance. Therefore, the research suggest women start to learn pelvic floor exercise after first-labored . And incontinent women should receive teaching to promote life quality and prevent medical wasting.