盆底肌训练联合阴道给药雌三醇对围绝经期全子宫切除术后盆底功能障碍影响研究

Effect of pelvic floor muscle training combined with vaginal administration of estriol on the pelvic floor dysfunction after peri-menopausal hysterectomy

目的探讨盆底肌训练联合阴道给药雌三醇对围绝经期全子宫切除术后盆底功能障碍的影响。方法选取2017年6月至2018年11月佛山市禅城区中心医院接收的67例行全子宫切除术后出现盆底功能障碍的围绝经期患者作为研究对象。随机分为观察组和对照组,对照组患者给予常规护理,观察组患者在常规护理基础上,给予盆底肌训练联合阴道给药雌三醇。比较两组患者治疗前、治疗6个月后盆底肌张力、膀胱功能改善情况,评价两组患者治疗6个月后性生活满意度,并对术后两组患者阴道分泌物清洁度、pH值阳性率、细菌性阴道炎发生率等进行对比。结果治疗前,两组患者阴道静息压(VRP)、阴道收缩压(VSP)、阴道收缩持续时间(PT)、残余尿量、膀胱颈移动度(BNP)相当,差异无统计学意义(P>0.05);观察组患者治疗6个月后VRP、VSP、PT、残余尿量、BNP较治疗前明显改善,差异具有统计学意义(P<0.05);观察组患者以上指标改善程度明显优于对照组患者,差异具有统计学意义(P<0.05);观察组患者治疗后阴道分泌物清洁度、pH值阳性率、细菌性阴道炎发生率(20.59%、20.59%、17.65%)明显低于对照组患者(9.09%、6.06%、6.06%),差异具有统计学意义(P<0.05);观察组患者治疗后性生活满意度91.17%明显高于对照组患者满意度66.66%,差异具有统计学意义(P<0.05)。结论盆底肌训练联合阴道给药雌三醇对于行全子宫切除术后出现盆底功能障碍的围绝经期妇女具有较好疗效,能显著促进盆底肌力及膀胱功能恢复,改善阴道微生态环境。

Objective To investigate the effect of pelvic floor muscle training combined with vaginal administration of estriol on the pelvic floor dysfunction after peri-menopausal hysterectomy. Methods From June 2017 to November 2018, 67 peri-menopausal patients with pelvic floor dysfunction after total hysterectomy in our hospital were selected and randomly divided into observation group and control group. Patients in the control group were given routine care. On the basis of routine nursing, the patients in the observation group were given pelvic floor muscle training combined with vaginal administration of estriol. The improvement in pelvic floor muscle tension and bladder function before and 6 months after treatment were compared between the two groups. The sexual life satisfaction in the two groups was evaluated after 6 months of treatment. The cleanliness of vaginal secretion, the positive rate of pH value and the incidence of bacterial vaginitis were compared between the two groups. Results Before treatment, the vaginal resting pressure(VRP), vaginal systolic pressure(VSP), vaginal contraction duration(PT), residual urine volume and bladder neck mobility(BNP) were comparable in the two groups, with no statistically significant differences(P>0.05). After 6 months of treatment, VRP, VSP, PT, residual urine volume and BNP were significantly improved compared with those before treatment, with statistically significant differences(P<0.05). The improvement in the above indicators in the observation group was significantly better than that in the control group, with statistically significant differences(P<0.05). The cleanliness of vaginal secretions, positive pH rate and incidence of bacterial vaginitis in the observation group(20.59%, 20.59%, 17.65%) were significantly lower than those in the control group(9.09%, 6.06%, 6.06%), with statistically significant differences(P<0.05). The sexual life satisfaction in the observation group(91.17%) was significantly higher than that in the control group(66.66%) after treatment, with statistically significant differences(P<0.05). Conclusions Pelvic floor muscle training combined with vaginal administration of estriol has a good effect on peri-menopausal women with pelvic floor dysfunction after hysterectomy, which can significantly promote pelvic floor muscle strength and bladder function recovery, and improve vaginal micro-ecological environment.