孕产期盆底功能训练指导对盆腔脏器脱垂的发病率及电刺激治疗效果的影响

Effect of the pelvic floor function training on the incidence rate of pelvic organ prolapse and electrical stimulation in the treatment of pelvic organ probpse

目的:评价孕产期盆底康复训练指导对盆腔脏器脱垂(POP)发病率及电刺激治疗效果的影响。方法:选取分娩并进行盆底肌力筛查及治疗病人1629例,分为对照组(795例)和观察组(834例)。对照组定期孕检,但未进行孕期干预,产后POP者进行盆底康复治疗。观察组定期孕检,进行孕期干预包括健康教育、饮食指导及质量管理、盆底肌肉锻炼,接受产后康复治疗,进行电刺激联合生物反馈治疗,并结合产妇盆底肌肉功能锻炼。产后42 d复查分析2组产妇发病情况,于产后6个月进行随访及复检,观察产妇POP改善状况。结果:产后42 d与观察组比较,对照组肌张力达到Ⅰ级和Ⅱ级肌力水平比例明显偏高,POP-Q结果显示,对照组SUI患病率(38.23%)明显高于观察组(28.89%)(P<0.05)。治疗6个月后肌拉力测试结果显示,2组Ⅰ级和Ⅱ级肌力水平比例明显减少,POP-Q结果显示2组SUI患病率明显下降,对照组SUI患病率高于观察组(P<0.05)。治疗6个月后POP-Q改善程度观察组明显优于对照组(P<0.05)。结论:孕产期盆底康复训练指导能够有效降低POP的发病率,并能够有效提高电刺激对盆底脏器脱垂的治疗效果。

Objective:To evaluate the effects of pelvic floor rehabilitation training on the incidence rate and electrical stimulation of pelvic organ prolapse(POP).Methods:A total of 1629 patients with delivery,pelvic floor muscle strength screening and treatment were divided into the control group(795 cases)and observation group(834 cases).In the control group,the regular pregnancy examination was conducted,no intervention during pregnancy was carried out,and the pelvic floor rehabilitation were implemented in patients with postpartum POP.In the observation group,the regular pregnancy examination and intervention during pregnancy(including health education,diet guidance,quality management and pelvic floor muscle training)were carried out,and the postpartum rehabilitation treatment,electrical stimulation combined with biofeedback therapy and maternal pelvic floor muscle function exercise were implemented.In two groups,the incidence of disease were analyzed at postpartum 42 d,and the improvement of puerpera POP were observed at postpartum 6 months.Results:At postpartum 42 d,compared with the observation group,the proportion of the gradeⅠandⅡmuscle tension in the control groups was higher,and the results of POP-Q showed that the prevalence rate of SUI in control group(38.23%)was significantly higher than that in observation group(28.89%)(P<0.05).At postpartum 6 moths,the results of the muscle tension test showed that the proportion of the gradeⅠandⅡmuscle tension in two groups significantly decreased.At postpartum 6 months,the results of POP-Q showed that the prevalence rate of SUI in two groups significantly decreased,and which in control group was higher than that in observation group(P<0.05).After 6 months of treatment,the improvement of POP-Q in observation group was significantly better than that in control group(P<0.05).Conclusions:The maternal pelvic floor rehabilitation training can effectively reduce the incidence rate of POP,and improve the effects of the electrical stimulation treatment.