两种方法对产后盆腔器官脱垂的疗效比较

Comparison of the therapeutic effect of two methods on pelvis organ prolapse rehabilitation

目的 比较盆底电刺激联合生物反馈与Kegel运动对产后盆腔器官脱垂康复的临床效果.方法 采用随机分组的方法,将222例盆腔器官脱垂产妇分为盆底电刺激联合生物反馈治疗研究组（92例）和Kegel运动治疗对照组（130例）进行康复训练,并对康复3个月后的效果进行比较分析.结果 两组产妇治疗后盆底浅层和深层、Ⅰ、Ⅱ类肌纤维肌力较治疗前均明显提升（对照组t值分别为-2.86、-3.50、-2.61、-3.23,均P〈0.05;研究组t值分别为-16.54、-14.65、-15.99、-14.06,均P〈0.01）,其中研究组治疗前后Aa、Ap、C、tvl、D、gh指标比较差异均有统计学意义（t值分别为-6.54、-2.99、-5.14、-2.09、-2.67、4.21,均P〈0.05）,对照组治疗前后Aa、gh指标比较差异有统计学意义（t值分别为-3.33、3.46,均P〈0.01）.治疗后两组结果比较Aa、C指标差异有统计学意义（t值分别为2.11、5.42,均P〈0.05）,表明研究组较对照组阴道前壁脱垂改善及宫颈位置上移明显.结论 电刺激联合生物反馈治疗及Kegel运动锻炼对产后妇女的盆底康复均有一定的作用,但电刺激联合生物反馈治疗较Kegel运动康复锻炼能更好地促进妇女盆底功能康复.

Objective To compare the clinical effect of electrical stimulation combined with biofeedback and Kegel exercises in pelvic organ prolapse （POP） rehabilitation. Methods 222 patients were randomly divided into study group （92 cases） for electrical stimulation combined with biofeedback and control group （ 130 cases） with Kegel exercises at home. The pelvic floor functions were examined and compared between two groups 3 months later. Results Pelvic floor muscle strength of superficial layer, deep layer, Ⅰ and Ⅱ fiber improved significantly in both groups （t value was - 2.86, - 3.50, - 2.61 and - 3.23 respectively in control group, all P 〈 0. 05 ; t value was - 16.54, - 14.65, - 15.99 and - 14.06 respectively in study group, all P 〈 0. 01 ）. The differences in Aa, Ap, C, tvl, D, gh indexes of the study group before and after treatment were significant （ t value was - 6. 54, - 2.99, - 5.14, - 2.09, - 2.67 and 4.21 respectively, all P 〈 0.05 ）, and the differences in Aa and gh indexes of the control group were also significant （t value was -3.33 and 3.46 respectively, P 〈 0. 01 ）. There were significant differences in Aa and C indexes between the study group and the control group （t value was 2.11 and 5.42 respectively, both P 〈 0. 05 ）, which showed that the vagina of the study group was improved and the cervix lifted more obviously than control group. Conclusion Both of the electrical stimulation combined with biofeedback and Kegel exercises demonstrate beneficial effect on pelvic floor disorders, while the former is proved to be better for rehabilitation of pelvic floor function.