生物反馈联合电刺激在产后盆底功能重建中的应用研究

Study on application of biofeedback combined with electrical stimulation in postpartum pelvic floor reconstruction

目的：分析生物反馈联合电刺激疗法对产后盆底功能障碍性疾病（PPFD）的治疗效果,为PPFD的治疗提供理论依据。方法：选取2013年3月-2014年6月在该院进行产后随访诊断为压力性尿失禁（SUI）的产妇151例,根据治疗意向分为治疗组（95例）和对照组（56例）,治疗组给予生物反馈＋盆底电刺激治疗＋盆底功能锻炼,观察组进行常规产后盆底功能锻炼,随访观察两组治疗效果。结果：产后3个月随访时,治疗组和对照组盆底肌最大收缩压分别为（39.97±6.77）μV和（37.56±4.33）μV,两组比较,差异有统计学意义（P〈0.05）。产后6个月随访时,治疗组和对照组的盆底肌的最大收缩压分别为（44.94±5.98）μV和（43.00±4.23）μV,持续收缩压分别为（32.96±5.19）μV和（30.14±5.36）μV,膀胱颈移动度分别为（26.38±3.86）mm和（29.16±5.21）mm,性生活质量评分分别为（68.21±7.20）分和（61.04±8.72）分,两组比较,差异均有统计学意义（P〈0.05）;两组治愈率、好转率和无效率比较差异有统计学意义（P〈0.05）。结论：生物反馈联合电刺激疗法可显著增加SUI的治愈率,促进产后盆底肌力和膀胱颈移动度恢复,并改善性生活质量,可在PPFD的治疗中推广应用。

Objective： To analyze the curative effect of biofeedback combined with electrical stimulation in treatment of postpartum pelvic floor dysfunction （PPFD）, provide a theoretical basis for PPFD treatment. Methods： A total of 151 puerperal women diagnosed as stress urinary incontinence （SUI） during postpartum follow - up in the hospital from March 2013 to June 2014 were selected and divided into treatment group （95 women） and control group （56 women） according to the intention -to -treat principle. The women in treatment group were treated with biofeedback therapy, electrical stimulation and pelvic floor exercise, while the women in control group were treated with routine pelvic floor exercise. The curative effects in the two groups were followed up and observed. Results： At three months after delivery, the maximum pelvic muscle contraction pressures in treatment group and control group were （39. 97 ±6. 77） μV and （37.56 ±4. 33） μV, respectively, there was statistically significant difference between the two groups （ P 〈 0. 05 ） . At six months after delivery, the maximum pelvic muscle contraction pressures in treatment group and control group were （44. 94 ± 5.98） μV and （43.00 ±4. 23 ） μV, respectively ; the continued pelvic muscle contraction pressures were （32.96 ±5.19 ） μV and （30. 14 ± 5.36） μV, respectively; the bladder neck mobility were （26. 38 ±3. 86） mm and （29. 16 ±5.21） mm, respectively; the scores of quality of sexual life were （68. 21 ±7. 20） and （61. 04 ±8.72 ） respectively ; there were statistically significant differences in the indexes above - mentioned between the two groups （ P 〈 0. 05 ）. There were statistically significant differences in cure rate, improvement rate and ineffective rate between the two groups （ P 〈 0. 05 ） . Conclusion： Biofeedback combined with electrical stimulation therapy can significantly increase the cure rate of SUI, promoting pelvic floor muscle and bladder neck mobility recovery and improving the quality of sexual life can be popularized and applied in treatment of PPFD.