盆底肌肉训练对产后盆底功能障碍的效果分析

Efficacy analysis of pelvic floor exercise on postpartum pelvic floor dysfunction

目的分析盆底肌肉训练对产妇产后盆底功能障碍的临床效果。方法选取2012年10月-2014年12月在本院分娩产妇,随访确诊为盆底功能障碍患者480例,随机分为观察组与对照组,每组240例。观察组患者产后6周开始接受盆底肌肉训练,采用法国PHENIX盆底康复训练系统治疗仪进行生物反馈及电刺激治疗,同时给予常规盆底肌肉训练指导,对照组给予常规盆底肌肉训练指导和健康教育。观察两组患者治疗效果。结果观察组患者盆底肌力治疗有效226例,有效率为94.17%,子宫脱垂治疗有效76例,有效率为90.48%,尿失禁治疗有效119例,有效率为95.97%。对照组患者盆底肌力治疗有效182例,有效率为75.83%,子宫治疗有效脱垂53例,有效率为60.92%,尿失禁治疗有效84例,有效率为70.00%。观察组盆底肌力治疗有效率、子宫脱垂治疗有效率及尿失禁治疗有效率均明显高于对照组,差异有统计学意义（P〈0.05）。观察组治疗后手测盆底肌力为（4.04±0.35）级,盆底Ⅰ类肌纤维肌电压为（8.08±1.56）μV,盆底Ⅱ类肌纤维肌电压为（8.11±1.51）μV,盆底Ⅰ类肌纤维疲劳度为（-0.02±0.02）%,盆底Ⅱ类肌纤维疲劳度为（0±0.01）%。对照组治疗后手测盆底肌力为（3.32±0.41）级,盆底Ⅰ类肌纤维肌电压为（5.05±1.24）μV,盆底Ⅱ类肌纤维肌电压为（5.42±1.33）μV,盆底Ⅰ类肌纤维疲劳度为（-0.04±0.02）%,盆底Ⅱ类肌纤维疲劳度为（-0.01±0.02）%。观察组盆底肌力各项指标均明显优于对照组,差异有统计学意义（P〈0.05）。结论盆底肌力训练对改善产后盆底功能障碍患者盆底肌力有显著效果,对改善尿失禁与子宫脱垂情况也起到有效作用,临床上值得推广。

Objective To analyze and explore the clinical effect of pelvic floor exercise on postpartum pelvic floor dysfunction. Methods 480 patients who were delivered in our hospital from October 2012 to December 2014 and were definitely diagnosed as pelvic floor dysfunction were selected.They were evenly divided into two groups,observation group and control group in random.In observation group,patients were received with pelvic floor exercise 6 weeks after delivery.PHENIX pelvic floor rehabilitation exercise system equipment was applied for biological feedback and electri-cal stimulation therapy was also used.Meanwhile,guidance of regular pelvic floor exercise was provided.In control group, guidance of regular pelvic floor exercise and health education were supplied.The therapeutic effect between two groups was observed. Results In observation group,there were 226 effective cases in the treatment of pelvic floor muscle strength accounting for 94.17%,76 effective cases on treating uterine prolapse for 90.48%,and 119 effective cases in urinary incontinence accounting for 95.97%.In control group,they were 182 （75.83%）,53 （60.92%）,and 84 （70.00%） re-spectively.Effective rates of pelvic floor muscle strength,uterine prolapse,and urinary incontinence in observation group was remarkably higher than that in control group respectively,with significant difference （P〈0.05）.After treatment,in ob-servation group,pelvic floor muscle strength tested by hand was （4.04±0.35）,pelvic floor Ⅰ and II muscle voltage of myofiber were[（8.08±1.56）,（8.11±1.51） μV],and fatigue in Ⅰ and II pelvic floor myofiber was（-0.02±0.02）% and （0±0.01）% in turn.In control group,after therapy,pelvic floor muscle strength tested by hand was（3.32±0.41）.Muscle voltage of myofiber in pelvic floor Ⅰ andIIwas[（5.05±1.24）,（5.42±1.33）μV] respectively.Fatigue of myofiber in pelvic floor玉and II was（-0.04±0.02）% and （-0.01±0.02）% in turn.In observation group,every index of pelvic floor muscle strength was remarkably superior to that in control group,with significant difference （P〈0.05）. Conclusion Pelvic floor exercise obtains a remarkable effect on improvement of patients with postpartum pelvic floor dysfunction and is also effective on improving urinary incontinence and uterine prolapse,which is worthy of expansion in clinical.