电刺激联合生物反馈治疗对女性盆底功能障碍性疾病的预防效果

Preventive effect of electric stimulation combined with biofeedback therapy on female pelvic floor dysfunction

目的:探讨电刺激联合生物反馈治疗对女性盆底功能障碍性疾病(pelvic floor dysfunction,PFD)的预防效果。方法:根据随机数表法将106例产后42 d的产妇分为对照组和观察组,每组各53例。对照组仅按照专业医师指导在家自行盆底肌训练,观察组接受为期4周的电刺激联合生物反馈治疗,然后在家接受专业医师指导自行盆底肌训练。随访观察两组盆底电生理指标变化和盆腔器官脱垂定量(pelvic organ prolapse quantitation,POP-Q)分度法情况,采用盆底功能影响问卷简表(PFIQ-7)和盆腔器官脱垂-尿失禁性功能问卷(PISQ-12)评估产后日常生活质量和性生活质量。结果:产后6个月,两组I、II类肌纤维肌力和阴道动态压力值较产后42 d时均有明显改善,且观察组上述盆底电生理指标较对照组改善更为显著,差异有统计学意义(P<0.05);对照组产后3、6个月盆腔POP-Q分级比较,差异无统计学意义(P>0.05);观察组产后6个月盆腔POP-Q分级优于产后3个月和对照组,差异有统计学意义(P<0.05);产后42 d、产后6个月,两组PISQ-12评分比较,差异无统计学意义(P>0.05),但观察组产后6个月PFIQ-7评分优于对照组(P<0.05)。结论:电刺激联合生物反馈治疗可显著改善产后盆底电生理指标,对预防PFD发生和改善产后生活质量有积极作用,值得临床推广运用。

Objective:To investigate the preventive effect of electric stimulation combined with biofeedback therapy on female pelvic floor dysfunction (PFD). Methods:106 postpartum 42 days pregnant women were divided into control group and observation group according to random number table method,53 cases in each group.The control group received home-based pelvic floor muscle training only under the guidance of professional doctors.The observation group received 4 weeks of electric stimulation combined with biofeedback therapy,and then received home-based pelvic floor muscle training under the guidance of professional doctors.The changes of pelvic floor electrophysiological indexes and pelvic organ prolapse quantification (POP-Q) were observed.The quality of postpartum daily life and sexual life were assessed by PFIQ-7 and PISQ-12. Results:The muscle strength of type Ⅰ and Ⅱ muscle fibers and vaginal dynamic pressure of the two groups at 6 months postpartum were significantly improved compared with those at 42 days postpartum,and the above-mentioned pelvic floor electrophysiological indexes in the observation group were improved more significantly than those in the control group ( P <0.05).There was no significant difference in the pelvic POP-Q classification of the control group at 3 and 6 months postpartum ( P >0.05).The pelvic POP-Q classification of the observation group at 6 months postpartum was better than that of the observation group at 3 months postpartum and that of the control group ( P <0.05).There was no significant difference in PISQ-12 score between the two groups at 42 days postpartum and 6 months postpartum ( P >0.05),but PFIQ-7 score in the observation group was better than that in the control group ( P <0.05). Conclusion:Electrical stimulation combined with biofeedback therapy can significantly improve the postpartum pelvic floor electrophysiological indicators,and play a positive role in preventing PFD and improving postpartum quality of life,which is worthy of clinical application.