摘要
目的 临床上对于轻中度女性盆底功能障碍主要以保守治疗为主,其中生物电刺激反馈治疗是目前最为理想的治疗方法,其操作简单、患者易于接受且临床效果理想。本研究探讨生物电刺激反馈治疗对产后盆底康复的临床效果。方法 选择2017-01-01—2018-03-31中山大学第三附属医院收治的80例经阴道分娩后盆底肌功能障碍产妇作为研究对象,按照年龄、产次、治疗前盆底Ⅰ和Ⅱ类肌肌张力及合并临床症状等因素组间均衡的原则选择观察组和对照组,各40例。对照组实施单纯盆底肌功能锻炼,观察组联合生物电刺激反馈治疗,对所有患者随访3个月,比较两组治疗后盆底肌电压及肌力、简易女性性功能及尿流动力学指标。结果 干预后3个月,观察组盆底肌电压为(14.1±1.3)μV,大于对照组的(6.1±0.4)μV,t=37.199,P<0.001;Ⅰ和Ⅱ类纤维盆底肌力分别为(4.2±0.3)和(4.2±0.5)级,均高于对照组的(1.4±0.1)和(1.0±0.2)级,t值分别为56.000和37.582,均P<0.001。干预3个月后,观察组性欲望(t=31.136,P<0.001)、性兴奋(t=26.830,P<0.001)、性高潮(t=79.171,P<0.001)、阴道润滑(t=76.012,P<0.001)和性交疼痛(t=30.589,P<0.001)评分均大于对照组,差异有统计学意义;性生活满意度为(4.3±0.3)分,高于对照组的(1.7±0.2)分,t=46.034,P<0.001。干预后3个月,观察组最大尿流量为(11.2±1.0)mL/s,高于对照组的(9.0±0.6)mL/s,t=11.931,P<0.001;膀胱顺应性为(36.2±2.1)cm H2O,大于对照组的(24.1±1.8)cm H2O,t=27.668,P<0.001;最大逼尿肌压力为(17.0±2.0)cm H2O,大于对照组的(12.0±0.6)cm H2O,t=287.747,P<0.001。结论 针对生产后盆底功能障碍者实施生物电刺激反馈治疗,能有效改善盆底肌肉功能及膀胱功能,提高性生活质量。
OBJECTIVE Clinically,conservative treatment is the main method for mild and moderate female pelvic floor dysfunction.Electric stimulation and biofeedback therapy are the most ideal treatment methods at present.Its operation is simple,easy for patients to accept,with satisfactory clinical effect.This study mainly discusses the clinical effect of bioelectric stimulation feedback therapy on postpartum pelvic floor rehabilitation.METHODS A total of 80parturients with pelvic floor dysfunction after vaginal delivery in the Third Affiliated Hospital of Sun Yat-sen University from January 1,2017to March 31,2018were selected as the study subjects.The observation group and control group were selected according to the principle of balance among age,parity,pre-treatment pelvic floor muscular tension of typeⅠandⅡand clinical symptoms,with 40cases in each group.The control group was treated with pelvic floor muscle exercise alone,while the observation group was treated with biofeedback electrical stimulation.All patients were followed up for 3months.The pelvic floor muscle voltage,muscle strength,simple female sexual function and urodynamic indexes were compared between the two groups after treatment.RESULTS Three months after intervention,the pelvic floor muscle voltage of the observation group was(14.1±1.3)μV,which was higher than that of the control group(6.1±0.4)μV,t=37.199,P<0.001.The pelvic floor muscle strength of typeⅠfibers and typeⅡfibers were(4.2±0.3)and(4.2±0.5)respectively,which were higher than those of the control group(1.4±0.1)and(1.0±0.2),with t values of 56.000 and 37.582,respectively,both P<0.001.After 3months of intervention,the scores of sexual desire(t=31.136,P<0.001),sexual excitement(t=26.830,P<0.001),orgasm(t=79.171,P<0.001),vaginal lubrication(t=76.012,P<0.001)and sexual intercourse pain(t=30.589,P<0.001)in the observation group were higher than those in the control group,and the differences were significant.The satisfaction of sexual life was(4.3±0.3)score,higher than that of the control group(1.7±0.2),t=46.034,P<0.001.Three months after intervention,the maximum urine flow rate in the observation group was(11.2±1.0)mL/s,higher than that in the control group(9.0±0.6)mL/s,t=11.931,P<0.001.Bladder compliance was(36.2±2.1)cm H2O,higher than that in the control group(24.1±1.8)cm H2O,t=27.668,P<0.001.The maximum detrusor pressure was(17.0±2.0)cm H2O,higher than that in the control group,(12.0±0.6)cm H2O,t=287.747,P<0.001.CONCLUISON Bioelectrical stimulation and feedback therapy for postpartum pelvic floor dysfunction can effectively improve pelvic floor muscle function,bladder function and sexual quality.
作者
郭严
王凤燕
GUO Yan;WANG Feng-yan(Department of Obstetrics,Third Affiliated Hospital of Sun Yat-sen University,Guangzhou510000,P.R.China;Department of Obstetrics,Puyang Oilfield General Hospital,Puyang457001,P.R.China)
出处
《社区医学杂志》
2019年第17期1080-1083,共4页
Journal Of Community Medicine
关键词
生物电刺激反馈治疗
盆底
功能锻炼
产后盆底康复
bioelectrical stimulation feedback therapy
pelvic floor
functional exercise
postpartum pelvic floor rehabilitation
