低频电刺激联合生物反馈治疗子宫切除术后盆底功能障碍的效果观察

Therapeutic efficacy of low-frequency electric stimulation combined with biofeedback therapy in pelvic floor dysfunction following hysterectomy

目的探讨低频电刺激联合生物反馈治疗(子宫全切或子宫次切)术后盆底功能障碍的临床效果。方法选择2017年6月~2019年2月在我院诊断治疗的子宫全切或次全切术后盆底功能障碍的患者100例为研究对象,随机分为观察组与对照组,每组50例。对照组实施盆底肌功能训练,观察组实施低频电刺激治疗及生物反馈治疗。比较两组治疗前后PFDI-20评分、最大尿流率、平均尿流率、排尿时间、残余尿、盆底电生理功能。结果(1)治疗后,两组PFDI-20评分较治疗前低,差异有统计学意义(P<0.05);观察组治疗后PFDI-20评分较对照组低,差异有统计学意义(P<0.05)。(2)治疗后,两组最大尿流率、平均尿流率均显著提高,与治疗前比较差异有统计学意义(P<0.05);两组排尿时间短于治疗前,残余尿量少于治疗前,差异有统计学意义(P<0.05)。治疗后,观察组相较于对照组,排尿时间更短,残余尿量更少,差异有统计学意义(P<0.05)。(3)治疗后,两组Ⅰ类肌纤维肌力、Ⅱ类肌纤维肌力均高于治疗前,差异有统计学意义(P<0.05);观察组治疗后Ⅰ类肌纤维肌力、Ⅱ类肌纤维肌力优于对照组,差异有统计学意义(P<0.05)。结论低频电刺激联合生物反馈治疗子宫切除术后盆底功能障碍可显著改善盆底电生理功能,改善排尿情况,改善症状。

Objective To investigate the therapeutic efficacy of low-frequency electric stimulation combined with biofeedback therapy in pelvic floor dysfunction following total or subtotal hysterectomy.Methods One hundred patients diagnosed as pelvic floor dysfunction following the treatment of total or subtotal hysterectomy in our hospital from June 2017 to February 2019 were selected as subjects.They were randomly divided into the observation group and the control group,with 50 cases in each group.Patients in the control group received pelvic floor muscle training and those in the observation group accepted low-frequency electric stimulation and biofeedback therapy.The Pelvic Floor Distress Inventory(PFDI-20)score,maximum urinary flow rate(Qmax),average urinary flow rate,voiding duration,volume of residual urine and electrophysiological function of pelvic floor muscle before and after treatment were compared between the two groups.Results(1)PFDI-20 scores significantly decreased after treatment in the two groups compared with the baseline,with significant differences(P<0.05).The score in the observation group was lower than that in the control group after treatment,with significant differences(P<0.05).(2)The Qmax and average urinary flow rates significantly increased after treatment in the two groups compared with the baseline levels(P<0.05).After treatment,the voiding duration was shorter and the volume of residual urine was lower than the baseline levels in the two groups,with statistically significant differences(P<0.05).However,the voiding duration was shorter and the volume of residual urine was lower in the observation group than those in the control group after treatment,with statistically significant differences(P<0.05).(3)The muscle strength of typeⅠandⅡmuscle fibers significantly improved in the two groups after treatment compared with the baseline levels,with statistically significant differences(P<0.05).The muscle strength of typeⅠandⅡmuscle fibers significantly improved in the observation group compared with the control group after treatment,with statistically significant differences(P<0.05).Conclusion Low-frequency electric stimulation combined with biofeedback therapy significantly improved the electrophysiological function of pelvic floor muscle in patients with pelvic floor dysfunction following hysterectomy,with ameliorated voiding function and symptoms.