盆底康复治疗产后阴道壁脱垂合并细菌性阴道病的临床研究

The clinical study of pelvic floor rehabilitation therapy of vaginal prolapse and bacterial vaginal disease

目的探讨盆底康复治疗（电刺激＋生物反馈治疗）用于产后阴道壁脱垂合并细菌性阴道病患者的临床效果。方法对产妇首先进行盆底肌力初次筛查，采用PHENIX机检测盆底Ⅰ、Ⅱ类纤维的肌力及阴道动态压力。对存在阴道壁脱垂合并细菌性阴道病患者155例按单盲法分为治疗组82例和对照组75例。治疗组根据PHENIXUSB4内置方案（脏器脱垂方案）进行盆底康复治疗5周，对照组进行盆底肌kegel训练5周。两组患者同时进行细菌性阴道病治疗。比较两组临床治疗效果。结果治疗组总有效率93．90％，优于对照组的74．67％（X^2=11．19，P〈0．05）。治疗组Aa点、Ap点值及POP—Q分期降低，阴道壁脱垂情况改善，盆底I类、Ⅱ类肌纤维肌力、阴道动态压力改善，与对照组差异均有统计学意义（均P〈0．05）。结论盆底康复治疗能明显改善产后患者阴道壁脱垂情况，且无损伤，无痛苦，疗效确切，治疗效果不受阴道炎影响，方法简便。

Objective To study the clinical effects of postpartum women with vaginal prolapse and bacterial vaginal disease on biofeedback combined with electrical stimulation used in pelvic muscle recover therapy,and explore the effectiveness of the treatment and the positive role, reduce the incidence of pelvic floor functional disease. Methods 157 cases of postpartum women who had detected pelvic floor Ⅰ,Ⅱ muscle fiber strength and vaginal dynamic pressure were selected for the study in our hospital,and divided into the treatment group （82 cases） and the control group group（75 cases）.The treatment group were observed on the basis of biofeedback combined with electri-cal stimulation therapy（ use of phenix USB4 treatment） .The control group were observed on the basis of Kegel exer-cise.Two groups had treatment of bacterial vaginal disease.Results The treatment group after treatment,total effec-tive rate was 93.90%,better than that of the control group.At the same time Aa point,Ap point and POP-Q was bet-ter,Vaginal prolapse was improved,pelvic floorⅠ,Ⅱmuscle fiber strength and vaginal dynamic pressure was signifi-cantly different compared the control group （χ^2 =11.19,P〈0.05） .Conclusion The pelvic floor rehabilitation ther-apy can improve the pelvic floor muscle strength of postpartum women,and improve the symptoms of pelvic organ pro-lapse.There was no pain and no damage.The treatment effect is not affected by vaginitis,and which is worthy of clini-cal application.