个体化盆底生物反馈电刺激对盆腔脱垂器官解剖和功能的影响

Effect of individualized electrical stimulation in pelvic muscles via bio-feedback on the anatomy and function of pelvic prolapsed organs

目的探讨个体化盆底生物反馈电刺激治疗盆腔脱垂对器官解剖复位和功能恢复的影响。方法入选120例盆腔器官脱垂患者,随机分组接受为期6个月的Kegel锻炼联合个体化生物反馈电刺激方案(治疗组,60例)和单纯Kegel锻炼(对照组,60例),比较两组干预后患者的器官解剖复位和功能恢复指标的变化。结果 (1)解剖位置方面:盆腔器官脱垂量化分期法比较,两组治疗后较治疗前明显改善(Z=6.790,P=0.000;Z=3.208,P=0.001),但治疗组患者的改善效果更佳(Z=3.530,P=0.000);(2)器官功能方面:两组治疗后的盆腔肌力均优于治疗前(Z=7.231,P=0.000;Z=1.995,P=0.037),但治疗组的疗效更好(Z=6.156,P=0.000);治疗后两组患者的最大尿流率较治疗前明显升高(P<0.05),两组残余尿量明显减少,治疗组更优于对照组(P<0.05);最大逼尿肌压在治疗前后差异无统计学意义(P>0.05)。结论个体化生物反馈电刺激治疗盆腔器官脱垂疗效良好、安全、无创伤性,值得在临床推广。

Objective To explore the effect of individualized electrical stimulation in pelvic muscles via bio-feedback on the anatomy and function of pelvic prolapsed organs. Methods A total of 120 patients with pelvic organ prolapse were randomized to two groups： treatment group（with individualized electrical stimulation in pelvic muscles via bio-feedback） and control group（with Kegel exercise only）. Parameters were analyzed, including pelvic organs anatomic and functional assessment. Results In terms of anatomic restoration, both groups had improved degrees and stages of prolapse according to the pelvic organ prolapse quantification（POP-Q）. Both groups had significantly improved pelvic muscle strength and the average and maximum urine flow rates（P〈0.05, respectively）. Compared to the control group, the improvement was even better in the treatment group（P〈0.05）. The postvoid residual was significantly decreased in both groups（P〈0.05）, especially in the treatment group. There was no significant change in the maximum pressure of detrusor contractile between before and after treatment（P〉0.05）. Conclusion Individualized electrical stimulation on pelvic muscles via bio-feedback associated with Kegel exercise is safe, atraumatic and worthy of application in POP treatment.