电刺激生物反馈及阴道哑铃Kegel锻炼治疗产后盆底功能障碍性疾病的临床效果分析

Clinical Effect Analysis of Electrical Stimulation Biofeedback Combined with Kegel Exercises in the Treatment of Postpartum Pelvic Floor Dysfunction

目的:探讨电刺激生物反馈联合阴道哑铃锻炼治疗产后盆底功能障碍性疾病的临床效果。方法:选择2018年3月至2019年3月我院产后综合管理门诊诊治的产后盆底功能障碍疾病(肌力<Ⅲ级伴有轻度压力性尿失禁和盆腔脏器脱垂Ⅰ~Ⅱ期)患者120例,根据随机数字表法分为两组,对照组60例使用阴道哑铃配合盆底肌肉锻炼(即Kegel运动)治疗;研究组60例采用盆底肌电刺激生物反馈疗法联合阴道哑铃Kegel锻炼治疗,比较两组患者治疗前后盆底肌力、压力性尿失禁及盆腔脏器脱垂程度变化。结果:治疗后两组患者盆底肌手测肌力、Ⅰ类肌纤维最大值、Ⅱ类肌纤维平均值情况较治疗前均有明显提升,且研究组患者盆底肌力、盆底Ⅰ类肌纤维最大值、Ⅱ类肌纤维平均值均明显优于对照组,差异有统计学意义(P<0.05);与治疗前相比,治疗后两组患者压力性尿失禁症状均有改善,有效率分别60.0%、85.0%,研究组有效率明显高于对照组,差异有统计学意义(P<0.05);治疗后两组患者盆腔器宫脱垂定量分期法(POP-Q)分期情况与治疗前比较差异有统计学意义(P<0.05),治疗后研究组与对照组比较差异有统计学意义(P<0.05)。结论:电刺激及生物反馈疗法联合阴道哑铃Kegel锻炼更有助于患者产后盆底肌力增强、压力性尿失禁及盆腔脏器脱垂症状改善,值得临床推广。

Objective:To investigate the clinical effect of biofeedback combined with electric stimulation and Kegel exercises in the treatment of postpartum pelvic floor dysfunction(PFD).Methods:One hundred and twenty patients with postpartum PFD(Muscle strength<levelⅢ,combined with mild stress incontinence and pelvic organ prolapsestageⅠ-Ⅱ)were selected from the postpartum comprehensive management clinic of our hospital be-tween March 2018 and March 2019.Patients were divided into two groups according to the random number table method.In the study group,60 patients were treated with the combination of biofeedback and electrical stimulation(BF+ES)of pelvic floor muscle plus Kegel exercises,while 60 patients in the control group were treated with only Kegel exercises.Changes of pelvic floor muscle strength,pressure incontinence and pelvic organ prolapse before and after treatment were compared between the two groups.Results:Pelvic floor muscle strength,classⅠmus-cle fibers and classⅡmuscle fibers of the two groups were significantly improved after treatment,and the study group had significantly greater improvements than the control group(P<0.05).Stress incontinence was also im-proved in the study group and the control group after treatment with the effective rate of 60.0%and 85.0%,re-spectively(P<0.05).POP-Q scores also significantly improved after treatment in both groups,with the study group a even greater improvement(P<0.05).Conclusions:BF+ES combined with Kegel exercises enables post-partum patients to enhance pelvic floor muscle strength,and improve stress urinary incontinence and pelvic organ prolapse symptoms,which is worthy of clinical application.