产后盆底康复治疗效果评价及其影响因素的Logistic回归分析

Evaluation of Postpartum Pelvic Floor Rehabilitation and the Logistic Regression Analysis of Its Influencing Factors

目的评价电刺激联合生物反馈疗法治疗产后盆底功能障碍的效果,分析影响治疗效果的因素。方法收集武汉协和医院2015年8月至2017年8月收治的200例产后盆底功能障碍病例,分为子宫脱垂组(36例),阴道壁膨出组(42例),压力性尿失禁组(25例),盆底肌张力减低组(97例),均采用电刺激联合生物反馈技术进行盆底康复治疗及训练,分析治疗前后各组临床症状及盆底肌力变化,评价产后盆底康复治疗的效果。同时采用多因素Logistic回归分析各组年龄、孕次、分娩方式、新生儿体重等因素与治疗效果的相关性。结果产后行电刺激联合生物反馈治疗后,产妇的临床症状、相关体征及盆底肌张力均有明显改善。多因素Logistic回归分析显示产次、分娩方式及新生儿体重与治疗效果明显相关(均P<0.05)。结论电刺激联合生物反馈是治疗产后盆底功能障碍的有效手段。妊娠次数越少、阴道分娩越少,新生儿体重越小,治疗效果越好。

Objective To evaluate the efficacy of electrical stimulation combined with bio feed back in the treatment of postpartum pelvic floor dysfunction and analyze the factors influencing the effed.Methods A total of 200 postpartum patients who received pelvic floor rehabilitation between August 2015 andAugust 201 7wcre enrolled in the study.Theywere divided into u-tcrine prolapse group(n=36.),vaginal wall bulging group(n=42.),stress urinary incontinence group(n=25)and pelvic floor muscle tone depression group(n=97).Al patients were treated with electrical stimulation combined with biofeed back technology for pelvic floor rehabilitation and training.The clinical symptoms and pelvic floor muscle strength were analyzed before and after treatment,and the effect of postpartum pelvic floor rehabilitation was evaluated.At the same time?multivariate logistic re gression was used to analyze the correlation between age,gravidity,delivery mode,neonatal weight and therapeutic effed.Results After the pelvic floor rehabilitation treatment,the clinical symptoms and the tension of the pelvic floor muscle of pa-tientswere obviously improved,and the multiple factor logistic regression analysis showed that the parity,the mode of delivery and the weight of the newborn were related to the effect of the trcatmcnt(P〈0.05).Conclusion Postpartumpclvic floor rehabilitation is an cfcctiveway to treat postpartum pelvic floor dysfunction.The treatment ismore effective forwomcn having fc-wer attempts of pregnancies and vaginal deliveries,and lower neonatal weigh.