盆底肌肉康复训练联合盆底重建术对产后盆底功能障碍性疾病患者盆底功能及盆底肌力的影响

Effects of Pelvic Floor Muscle Rehabilitation Training Combined with Pelvic Floor Reconstruction on Pelvic Floor Function and Pelvic Floor Muscle Strength in Patients with Postpartum Pelvic Floor Dysfunction

目的探讨盆底肌肉康复训练联合盆底重建术在产后盆底功能障碍性疾病(PFD)患者中的应用效果.方法选取2019年4月-2021年1月我院收治的88例产后PFD患者为研究对象,按随机数字表法分为两组,每组44例.对照组采用盆底重建术,试验组在对照组基础上采用盆底肌肉康复训练,持续训练1个月,随访至术后6个月.对比两组的盆底功能、盆底肌力、生活质量及压力性尿失禁发生情况.结果术前,两组的盆底功能比较,差异无统计学意义(P>0.05);术后6个月,试验组的盆底功能障碍问卷简表评分为(20.41±5.28)分,低于对照组的(28.39±6.22)分,差异有统计学意义(P<0.05).术前,两组的盆底肌张力对比,差异无统计学意义(P>0.05);术后6个月,试验组的阴道静息压、阴道收缩压均高于对照组,阴道收缩持续时间长于对照组,组间差异有统计学意义(P<0.05).术前,两组的生活质量比较,差异无统计学意义(P>0.05);术后6个月,试验组的世界卫生组织生存质量测定量表中的生理领域、心理领域、社会领域、环境领域评分均高于对照组,组间差异有统计学意义(P<0.05).试验组的压力性尿失禁发生率为4.55%,低于对照组的18.18%,差异有统计学意义(P<0.05).结论盆底肌肉康复训练联合盆底重建术可修复产后PFD患者的盆底功能,增强盆底肌力,减少尿失禁的发生,从而减轻疾病的负面影响,提高患者生活质量.

Objective To investigate the application effect of pelvie floor musele rehabilitation training combined with pelvic floor reconstruction on patients with postpartum pelvic floor dysfunctional disease(PFD).Methods 88 patients with postpartum PFD admitted to our hospital from April 2019 to January 2021 were selected as research subjects,and were divided into two groups according to the random number table method,with 44 cases in each group.In the control group,pelvic floor reconstruction was used,and in the test group,pelvic floor muscle rehabilitation training was used on the basis of the control group,and both groups continued training for 1 month and were followed up until 6 months after surgery.The pelvic floor function,pelvic floor musele strength,quality of life and occurrence of stress urinary incontinence were compared between the two groups.Results Before surgery,the pelvic floor function of the two groups was compared,and the difference was not statistically significant(P>0.05);6 months after surgery,the pelvic floor distress inventory-short form 20 score of the test group was(20.41±5.28)points,which was lower than that of the control group(28.39±6.22)points,and the difference was statistically significant(P<0.05).Before surgery,the pelvic floor muscle tone of the two groups was compared,and the difference was not statistically significant(P>0.05);6 months after surgery,the vaginal resting pressure and vaginal systolic pressure in the test group were higher than those in the control group,and the duration of vaginal contraction was longer than that in the control group,and the differences between the groups were statistically significant(P<0.05).Before surgery,there was no statistically significant difference in the quality of life between the two groups(P>0.05);6 months after surgery,the scores of physical,psychological,social,and environ mental do mains in the world health organization quality of life were higher in the test group than in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of stress urinary incontinence in the test group was 4.55%,which was lower than that in the control group of 18.18%,and the difference was statistically significant(P<0.05).Conclusion Pelvic floor muscle rehabilitation training combined with pelvic floor reconstruction can repair the pelvic floor function of postpartum PFD patients,enhance pelvic floor muscle strength,and reduce the occurrence of urinary incontinence,thus reducing the negative effects of the disease and improving patients'quality of life.