电刺激联合生物反馈治疗对改善产后盆底功能的效果观察
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摘要
目的观察电刺激联合生物反馈治疗对改善产后女性盆底肌肌力及盆底功能的效果,同时探讨其在临床上的应用价值。方法选取2017年11月-2018年10月于山西省某院分娩并复查的女性352例作为研究对象,采用随机数字表法将患者分为训练组(n=235),观察组(n=117)。训练组患者分2个阶段进行电刺激联合生物反馈治疗,每个阶段治疗时间为2周,每周进行2次治疗,治疗次数共8次。观察组患者予以常规康复指导,不予特殊干预,自然恢复。于产后42d、产后6个月时对2组患者进行盆底电生理检测、盆底功能障碍影响简易问卷调查、盆腔器官脱垂/尿失禁性功能问卷调查,观察电刺激联合生物反馈治疗对产后女性早期盆底肌肌力及盆底功能的临床效果。结果产后42d,2组患者I类肌纤维的肌力及疲劳度、Ⅱ类肌纤维的肌力及疲劳度、阴道最大动态压力比较,差异均无统计学意义(P>0.05);产后6个月,训练组患者I类肌纤维的肌力及疲劳度、Ⅱ类肌纤维的肌力、阴道最大动态压力明显高于观察组,差异有统计学意义(P<0.05);产后6个月,2组患者Ⅱ类肌纤维的疲劳度比较,差异无统计学意义(P>0.05)。产后42d,盆底功能障碍影响简易问卷中,2组患者各题选择有影响的人数比例比较,差异无统计学意义(P>0.05);产后6个月,盆底功能障碍影响简易问卷中,训练组患者各题选择有影响的人数比例均低于观察组,差异有统计学意义(P<0.05)。产后42d,2组患者有性生活人数均较少,盆腔器官脱垂/尿失禁性功能问卷评分比较,差异无统计学意义(P>0.05);产后6个月,训练组患者盆腔器官脱垂/尿失禁性功能问卷评分高于观察组,差异有统计学意义(P<0.05)。结论产后早期电刺激联合生物反馈训练可改善患者盆底肌肌力及盆底功能障碍,具有良好的临床效果,值得推广应用。
Objective To assess the efficacy of electrostimulation combined with biological feedback in improving postpartum pelvic floor muscle strength and its function,and also explore its utility in clinical practice.Methods A total of352 women who delivered and returned for postpartum checkups in a Shanxi hospital between November 2017 and October 2018 were included in this study.Based on a random number table,these women were allocated into the training group(n=235)and the control group(n=117).For patients in the training group,electrostimulation plus biological feedback were administered twice a week,two weeks as one cycle,for two cycles(8 treatment sessions in total);for those in the control group,routine counselling and observation were performed,without any specific intervention.At 42 days and 6 months after delivery,electrophysiological study of pelvic floor musculature,Pelvic Floor Impact Questionnaire Short Form(PFIQ),and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ)were used to assess the clinical efficacy of electrostimulation combined with biological feedback in improving postpartum pelvic floor muscle strength and its function.Results At 42 days after delivery,type I muscle fiber strength and fatigue,type II muscle fiber strength and fatigue,and vaginal maximum dynamic pressure were similar between the two groups(P>0.05).At 6 months after delivery,type I muscle fiber strength and fatigue,typeⅡ muscle fiber strength,and vaginal maximum dynamic pressure in the training group were significantly higher than those in the control group(P<0.05),but type II muscle fiber fatigue was similar between the two groups(P>0.05).At 42 days after delivery,the proportions of patients who answered yes to the PFIQ questions were comparable between the two groups(P>0.05).At 6 months after delivery,the proportions of patients who answered yes to the bladder/urine and vagina/pelvis questions in PFIQ in the training group were significantly lower than those in the control group(P<0.05).At 42 days after delivery,the proportion of patients who had sexual activities was low and similar in the two groups(P>0.05).At 6 months after delivery,the PISQ score in the training group was significantly higher than that in the control group(P<0.05).Conclusion Electrostimulation combined with biological feedback in early postpartum stage seems to be effective in improving pelvic floor muscle strength and its function,which deserves widespread clinical application.
Objective To assess the efficacy of electrostimulation combined with biological feedback in improving postpartum pelvic floor muscle strength and its function,and also explore its utility in clinical practice.Methods A total of352 women who delivered and returned for postpartum checkups in a Shanxi hospital between November 2017 and October 2018 were included in this study.Based on a random number table,these women were allocated into the training group(n=235)and the control group(n=117).For patients in the training group,electrostimulation plus biological feedback were administered twice a week,two weeks as one cycle,for two cycles(8 treatment sessions in total);for those in the control group,routine counselling and observation were performed,without any specific intervention.At 42 days and 6 months after delivery,electrophysiological study of pelvic floor musculature,Pelvic Floor Impact Questionnaire Short Form(PFIQ),and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ)were used to assess the clinical efficacy of electrostimulation combined with biological feedback in improving postpartum pelvic floor muscle strength and its function.Results At 42 days after delivery,type I muscle fiber strength and fatigue,type II muscle fiber strength and fatigue,and vaginal maximum dynamic pressure were similar between the two groups(P>0.05).At 6 months after delivery,type I muscle fiber strength and fatigue,typeⅡ muscle fiber strength,and vaginal maximum dynamic pressure in the training group were significantly higher than those in the control group(P<0.05),but type II muscle fiber fatigue was similar between the two groups(P>0.05).At 42 days after delivery,the proportions of patients who answered yes to the PFIQ questions were comparable between the two groups(P>0.05).At 6 months after delivery,the proportions of patients who answered yes to the bladder/urine and vagina/pelvis questions in PFIQ in the training group were significantly lower than those in the control group(P<0.05).At 42 days after delivery,the proportion of patients who had sexual activities was low and similar in the two groups(P>0.05).At 6 months after delivery,the PISQ score in the training group was significantly higher than that in the control group(P<0.05).Conclusion Electrostimulation combined with biological feedback in early postpartum stage seems to be effective in improving pelvic floor muscle strength and its function,which deserves widespread clinical application.
引文
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[7]洪莉.盆底功能障碍性疾病康复治疗的评价[J].中国计划生育和妇产科,2016,8(8):1-2.DOI:10.3969/j.issn.1674-4020.2016.08.01.
[8]张燕.女性盆底肌康复治疗的研究进展[J].中外女性健康研究,2018(5):86.
[9]李连.生物反馈电刺激治疗对产后盆底功能障碍产妇生命质量的影响[J].医疗装备,2018,31(20):138-139.DOI:CNKI:SUN:YLZB.0.2018-20-104.
[10]曾梅.电刺激加生物反馈对提高盆底肌收缩力的效果观察[J].中医临床研究,2018,10(9):145-147.DOI:CNKI:SUN:ZYLY.0.2018-09-078
[11]黄武.电刺激联合生物反馈治疗产后盆底肌康复效果[J/CD].心电图杂志:电子版,2018,7(3):39-40.
[12]刘霞,王祥珍,张丹.电刺激联合生物反馈治疗对女性产后性功能障碍的疗效评估[J].中国妇幼健康研究,2018,29(7):906-910.DOI:10.3969/j.issn.1673-5293.2018.07.021.
[2]王梅,罗新.高龄产妇盆底康复治疗研究现状[J].中国计划生育和妇产科,2017,9(5):11-14.DOI:CNKI:SUN:JHFC.0.2017-05-004.
[3]吴晓燕,何名梅,黄清.女性盆底功能障碍性疾病的流行病学及相关因素研究进展[J].微量元素与健康研究,2015,32(3):59-61.
[4] TINELLI A,MALVASI A,RAHIMI S,et al.Age-related pelvic floor modifications and prolapse risk factors in postmenopausal women[J].Menopause,2010,17(1):204-212.DOI:10.1097/gme.0b013e3181b0c2ae.
[5]夏咸梅.电刺激加生物反馈治疗盆底功能障碍性疾病效果的观察与研究[J].中外女性健康,2014(9):51.
[6]周菊花.产后康复治疗对改善盆底功能的临床效果观察[J].临床医学研究与实践,2016,1(1):68-69.DOI:10.19347/j.cnki.2096-1413.2016.01.050.
[7]洪莉.盆底功能障碍性疾病康复治疗的评价[J].中国计划生育和妇产科,2016,8(8):1-2.DOI:10.3969/j.issn.1674-4020.2016.08.01.
[8]张燕.女性盆底肌康复治疗的研究进展[J].中外女性健康研究,2018(5):86.
[9]李连.生物反馈电刺激治疗对产后盆底功能障碍产妇生命质量的影响[J].医疗装备,2018,31(20):138-139.DOI:CNKI:SUN:YLZB.0.2018-20-104.
[10]曾梅.电刺激加生物反馈对提高盆底肌收缩力的效果观察[J].中医临床研究,2018,10(9):145-147.DOI:CNKI:SUN:ZYLY.0.2018-09-078
[11]黄武.电刺激联合生物反馈治疗产后盆底肌康复效果[J/CD].心电图杂志:电子版,2018,7(3):39-40.
[12]刘霞,王祥珍,张丹.电刺激联合生物反馈治疗对女性产后性功能障碍的疗效评估[J].中国妇幼健康研究,2018,29(7):906-910.DOI:10.3969/j.issn.1673-5293.2018.07.021.