盆底肌肉训练对女性盆底功能障碍性疾病的康复效果

Efficacy of pelvic floor muscle training in the treatment of female pelvic floor dysfunction

目的评价盆底肌肉训练对盆底肌肉张力的影响及对盆底功能的作用。方法选择在门诊进行产后42 d复查的妇女,其中盆底肌力测定<Ⅲ级者作为产后组(80例),分为训练组(50例)和对照组(30例);同期张力性尿失禁患者45例(其中5例为产后尿失禁)作为尿失禁组,子宫脱垂≤Ⅱ度患者23例(其中合并尿失禁6例)作为子宫脱垂组。产后训练组、尿失禁组及子宫脱垂组均采用盆底肌肉训练(每周2次,10次为一疗程),产后对照组进行健康教育及产后操锻炼。各组患者治疗前后进行盆底肌力测定。结果产后训练组、尿失禁组、子宫脱垂组及产后对照组有效率分别为91.5%、46.7%、21.7%和20.0%。产后训练组与对照组比较差异有统计学意义(P<0.05),产后训练组治疗后盆底肌电活动高于对照组,差异有统计学意义(P<0.05)。结论盆底肌肉训练能有效提高肌肉张力,产后42 d开始治疗效果更好。

Objective To evaluate the efficacy of pelvic floor muscle training （PFMT） on the tension and func- tion of pelvic floor muscle. Methods From January to December 2010, postpartum women with pelvic floor muscle ten- sion lower than III were included （80 cases and divided into training group （50 cases） and control group （30 cases）. During the same period, 45 cases of stress urinary incontinence （SUI group） and 23 cases of uterine prolapse severer than II （prolapse group） were also included in the study. PFMT was preformed in postpartum training group, SUI group and prolapse group （twice a week for ten times）. Health education and postpartum exercises were adopted in postpartum con- trol group. Pelvic floor muscle tension evaluation was taken before and after the treatment. Results The effective rate was 91.5%, 46. 7%, 21.7% and 20. 0% in postpartum training group, SUI group, prolapse group and postpartum control group, respectively, with significant difference between postpartum training group and control group （ P 〈 0. 05 ）. Pelvic floor musculoelectric activity was significantly higher in postpartum training group than control group after treatment （P 〈 0. 05）. Conclusion PFMT can effectively improve pelvic floor muscle tension. The treatment should be applied as early as 42 days after delivery to archive the best effect.