生物电刺激治疗不同分娩方式产后盆底肌力减退的比较研究

Therapeutic Effect of the Biofeedback Combined with Electrical Stimulation on Postpartum Pelvic Floor Dysfunction with Different Delivery Mode

目的:观察顺产和剖宫产者产后发现盆底肌力减退后,采用生物反馈联合电刺激的治疗效果。方法:选取产后42天复诊时经筛查发现存在重度盆底肌力减退的产妇101例,其中经阴道分娩51例,剖宫产50例。产后42天用PHENIX检测仪量化评估盆底肌力后,采用生物反馈联合电刺激治疗10次,在产后3个月和6个月再次检测产妇盆底肌力情况。16例未治疗阴道分娩产妇作为对照组。结果:经阴道分娩组和剖宫产组重度盆底肌力减退患者Ⅰ类肌力和Ⅱ类肌力评分在治疗后较治疗前(产后42天)均有显著增高(P<0.01)。经阴道分娩组和剖宫产组比较,治疗前(产后42天)盆底肌力评分差异无统计学意义(P>0.05),治疗后产后3个月两组Ⅰ、Ⅱ类肌力评分比较差异无统计学差异(P>0.05);产后6个月经阴道分娩组的Ⅰ、Ⅱ类肌力评分均高于剖宫产组,差异有统计学意义(P<0.05)。经阴道分娩组和剖宫产组治疗后产后3月与产后6月的Ⅰ、Ⅱ类肌力评分均显著高于对照组,P<0.05。结论:生物反馈联合电刺激治疗重度盆底肌力减退疗效显著。对剖宫产产后发生重度盆底肌力减退者需要强化疗程。

Objective：To evaluate the therapic effectiveness of biofeedback combined with electrical stimulation on severe postpartum pelvic floor dysfunction after vaginal delivery or cesarean section. Methods ：101 cases of severe pelvic floor dysfunction diagnosed at 42 days postpartum visit were selected to undergo ten times therapy of biofeedback combined with electrical stimulation, including 51 cases of vaginal birth and 50 ca- ses of cesarean section. Quantitative reassessment of the maternal pelvic floor muscle strength of type [ and type ]] were done using the PHENIX tester at 3 months and 6 months postpartum. Results： Regardless of vaginal delivery or cesarean section, type Ⅰ and type Ⅱ severe pelvic floor muscle strength decline in patients increased significantly after one therapy procedure of biofeedback combined with electrical stimulation （P 〈 O. 01 ）, type Ⅰ and type Ⅱ of pelvic floor muscle strength continued to increase in vaginal birth group at 3months and 6monthes, otherwise, comparing to the 3 months and 6 months, typeⅠ muscle strength remained, while the class HE strength decreased slightly in cesarean section group. Conclusions： Biofeedback electrical stimulation in treatment of severe pelvic floor dysfunction may have obvious curative effect. More therapy procedures should be needed in severe postpartum pelvic floor dysfunction patients after cesarean section.