骨盆底功能障礙是一種影響女性骨盆器官正常功能的疾病,包括腸道、泌尿道、骨盆支撐和性功能等各方面的障礙。陰道分娩和相關創傷被認為是骨盆底損傷的主要致病原因。特別的生產因素,例如巨大胎兒和器械助產,可能造成更大的骨盆底損傷。此外,更年期相關的荷爾蒙變化和結締組織特性,與骨盆底症狀的發生亦有相關。 膀胱過動症候群(Overactive bladder syndrome, OAB)是一種常見的骨盆底功能障礙,國際尿失禁防治協會(ICS)將膀胱過動症定義為「尿急,可能有急迫性尿失禁,通常伴隨發生頻尿及夜尿」。目前膀胱過動症候群的第一線治療方法是行為治療,包括骨盆底肌肉自主運動(凱格爾運動)、生物回饋、電刺激和電磁刺激治療等。
高強度聚焦電磁技術
高強度聚焦電磁技術(High-intensity focused electromagnetic technology, HIFEM)應用法拉第的電磁感應定律,由此產生即時變動的磁場感應電流,用於刺激中樞和周圍神經系統,誘導神經去極化,導致骨盆肌肉收縮並且調控第2節至第4節(S2-S4)的薦椎神經反應。由於此一特性,高強度聚焦電磁技術已被應用於治療各類型的尿失禁及膀胱過動症。在治療過程中,主要是刺激會陰部神經,重複的刺激活化末端運動神經纖維會增強骨盆底肌肉(包括尿道括約肌)的張力和耐力,改善尿失禁;並且透過中樞神經防衛反射,抑制膀胱逼尿肌收縮,改善頻尿、急尿等膀胱過動症的相關症狀。與其他形式的骨盆肌肉強化治療類似,高強度聚焦電磁技術使尿道橫紋括約肌產生肥大效應,亦有助於抑制膀胱的急尿感。
由於高強度聚焦電磁技術沒有直接活化C型神經纖維和皮膚的感覺受體,不會造成疼痛不適,比傳統的電刺激更舒適。因此高強度聚焦電磁技術於1998年獲得美國食品藥物管理局批准核可用於治療尿失禁等醫療用途。
磁波椅 – 肌緊椅
最新的UI CUBE肌緊椅(圖二)採用目前最高強度(2.5特斯拉)聚焦電磁技術的治療裝置,其結構由一個發電機和一個內部安裝的圓形線圈所組成。相較於一般推薦應用的凱格爾運動,磁波椅儀器裝置應用高強度聚焦電磁技術,能達到更有效率、更加強化的骨盆底肌肉收縮訓練。接受 20分鐘的治療可以達到12,000次凱格爾運動的效果,將凱格爾運動的益處最佳化,並且透過強化盆底肌肉來增加自主肌肉收縮力量,使尿道橫紋括約肌產生肥大效應,有助於抑制膀胱的急尿感;並且經由中樞神經防衛反射,抑制膀胱逼尿肌收縮,改善膀胱過動症候群的相關症狀。
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