盆底物理康复治疗对更年期女性盆底肌功能障碍的疗效分析

Efficacy analysis of pelvic floor physical rehabilitation on pelvic floor dysfunction in menopausal women

目的研究盆底物理康复治疗对更年期女性盆底肌功能障碍(PFD)的自我修复及功能影响。方法收集2017年6月至2018年6月期间在杭州市余杭区第一人民医院就诊的中老年PFD患者84例作为研究对象,利用随机数字表法将其分为治疗组(自主盆底肌锻炼+盆底物理康复治疗,n=42)和对照组(自主盆底肌锻炼,n=42),分别干预3个月后,观察两组的治疗效果。结果干预前,两组Ⅰ类及Ⅱ类肌纤维疲劳度、盆腔动态压力、1h尿垫试验漏尿量及子宫脱垂程度无显著统计学差异(均P>0.05)。治疗组干预后Ⅰ类及Ⅱ类肌纤维疲劳度及1h尿垫试验漏尿量均较干预前显著降低,干预后盆腔动态压力较干预前显著升高(t值分别为56.08、27.31、23.85、-11.85,均P<0.05)。干预后,治疗组Ⅰ类及Ⅱ类肌纤维疲劳度均显著低于对照组(t值分别为30.43、12.93,均P<0.05),盆腔动态压力显著高于对照组(t=5.73,P<0.05);1h尿垫试验漏尿量显著少于对照组(t=-9.78,P<0.05);子宫脱垂程度显著轻于对照组(P<0.05)。结论盆底物理康复治疗能有效提高更年期PFD妇女盆底肌自我恢复能力,改善盆底肌纤维疲劳与盆腔动态压力,减轻患者尿失禁及子宫脱垂程度,是一种安全有效的治疗方式。

Objective To investigate the effect of physical rehabilitation on self-recovery and function of pelvic floor dysfunction(PFD)in menopausal women.Methods A total of 84 cases of menopausal women with PFD and treated in the First People’s Hospital of Yuhang District from June 2017 to June 2008 were enrolled.Using the method of random numbers table,all of them were randomly divided into treatment group and control group,each with 42 cases.Treatment group received the physical rehabilitation treatment combined with voluntary pelvic floor exercise,and the control group received voluntary pelvic floor exercise.After 3 months of intervention,the therapeutic effects of the two groups were observed.Results Before intervention,there were no significant differences in the typeⅠandⅡmuscle fiber fatigue,dynamic pelvic pressure,urine leakage in one-hour pad test and the degree of uterine prolapse between the two groups(all P>0.05).Compared with before intervention,the typeⅠandⅡmuscle fiber fatigue and urine leakage in one-hour pad test in the treatment group after intervention were all significantly reduced,while dynamic pelvic pressure was significantly increased(t=56.08,27.31,23.85 and-11.85,respectively,all P<0.05).After intervention,the typeⅠandⅡmuscle fiber fatigue in the treatment group were all significantly lower than in the control group(t=30.43 and 12.93,respectively,both P<0.05);dynamic pelvic pressure was significantly higher than that of the control group(t=5.73,P<0.05);the urine leakage in one-hour pad test was significantly lower than that in the control group(t=-9.78,P<0.05);the degree of uterine prolapse was significantly less than that of the control group(P<0.05).Conclusion Physical rehabilitation therapy of pelvic floor can effectively improve the self-recovery ability of pelvic floor muscles in menopausal PFD women,improve pelvic floor muscle fiber fatigue and dynamic pelvic pressure,and reduce urinary incontinence and uterine prolapse,which is a safe and effective treatment in clinic.