生物反馈电刺激联合Kegel训练对产后盆底功能障碍患者盆底肌力、盆底结构及生活质量的影响

Effects of Biofeedback Electrical Stimulation Combined with Kegel Training on Pelvic Floor Muscle Strength,PelvicFloor Structure and Quality of Life in Postpartum Patients with Pelvic Floor Dysfunction

目的探讨产后盆底功能障碍患者接受生物反馈电刺激联合Kegel训练对盆底肌力、盆底结构及生活质量的影响。方法选取2020年2月—2023年2月该院接诊的78例产后盆底功能障碍患者为研究对象。根据随机数字表法将其分为对照组和观察组,每组39例。对照组患者接受Kegel训练,观察组患者接受生物反馈电刺激联合Kegel训练。对比两组盆底肌力、Ⅰ类肌纤维最大值、Ⅱ类肌纤维平均值、肛提肌厚度、肛提肌裂孔面积、盆底疾病生活质量影响问卷短表-7(PFIQ-7)和盆腔器官脱垂-尿失禁性功能问卷(PISQ-12)评分。结果干预前,两组患者盆底肌力、Ⅰ类肌纤维最大值和Ⅱ类肌纤维平均值比较,组间差异无统计学意义(P>0.05);干预后,观察组盆底肌力、Ⅰ类肌纤维最大值和Ⅱ类肌纤维平均值均高于对照组,组间差异有统计学意义(P<0.05)。干预前,两组患者缩肛状态、静息状态的肛提肌厚度和肛提肌裂孔面积比较,组间差异无统计学意义(P>0.05);干预后,观察组缩肛状态、静息状态的肛提肌厚度均厚于对照组,组间差异有统计学意义(P<0.05)。观察组缩肛状态、静息状态的肛提肌裂孔面积均小于对照组,组间差异有统计学意义(P<0.05)。干预前,两组患者PFIQ-7、PISQ-12评分比较,组间差异无统计学意义(P>0.05);干预后,观察组PFIQ-7、PISQ-12评分均低于对照组,组间差异有统计学意义(P<0.05)。结论产后盆底功能障碍患者接受生物反馈电刺激联合Kegel训练,可明显提高盆底肌力,促进肛提肌裂孔面积复原,提升肛提肌厚度,同时提高生活质量。

Objective To investigate the effects of biofeedback electrical stimulation combined with Kegel training on pelvic floor muscle strength,pelvic floor structure and quality of life in postpartum patients with pelvic floor dysfunction.Methods 78 patients with postpartum pelvic floor dysfunction admitted to the hospital from February 2020 to February 2023 were selected as the research objects.According to the random number table method,they were divided into a control group and an observation group,with 39 cases in each group.The control group received Kegel training,and the observation group received biofeedback electrical stimulation combined with Kegel training.The pelvic floor muscle strength,maximum value of type Ⅰ muscle fiber,mean value of type Ⅱ muscle fiber,levator ANI muscle thickness,levator ANI hiatus area,Pelvic Floor quality of life impact questionnaire short form 7(PFIQ-7)and pelvic organ prolapse-urinary incontinence sexual function questionnaire(PISQ-12)scores were compared between the two groups.Results Before the intervention,there were no significant difference in the pelvic floor muscle strength,the maximum value of type Ⅰ muscle fiber and the average value of type Ⅱ muscle fiber between the two groups(P>0.05);after the intervention,the pelvic floor muscle strength,the maximum value of type Ⅰ muscle fiber and the average value of type Ⅱ muscle fiber in the observation group were higher than those in the control group,and the differences between the two groups were statistically significant(P<0.05).Before intervention,there were no statistically significant difference in levator ANI muscle thickness and levator ANI hiatus area between the two groups in the contraction state and the resting state(P>0.05);after intervention,the thickness of levator ANI muscle in the contraction state and resting state of the observation group was thicker than that of the control group,and the differences between the two groups were statistically significant(P<0.05).The area of levator hiatus in the contraction state and resting state in the observation group was smaller than that in the control group,and the differences between the two groups were statistically significant(P<0.05).Before the intervention,there were no significant difference in the scores of PFIQ-7 and PISQ-12 between the two groups(P>0.05);after intervention,the scores of PFIQ-7 and PISQ-12 in the observation group were lower than those in the control group,and the differences between the two groups were statistically significant(P<0.05).Conclusion Biofeedback electrical stimulation combined with Kegel training for postpartum patients with pelvic floor dysfunction can significantly improve pelvic floor muscle strength,promote the recovery of levator ANI hiatus area,improve the levator ANI muscle thickness,and improve the quality of life.