盆底肌锻炼结合生物反馈刺激改善产后盆底疼痛患者盆底功能及疼痛程度的效果分析

Pelvic floor muscle exercise combined with biofeedback stimulation to improve pelvic floor function and pain degree in patients with postpartum pelvic floor pain

目的:探讨盆底肌锻炼结合生物反馈刺激改善产后盆底疼痛患者盆底功能及疼痛程度的效果。方法:将我科2018年9月至2019年9月期间93例产后盆底疼痛患者按照简单随机化法分为对照组(n=46,给予生物反馈电刺激,频率8~80 Hz;脉宽:20~740μs)和观察组(n=47,在对照组基础上增加盆底肌锻炼),1 m后采用阴道彩超观察患者盆底功能水平(静息状态下阴道静息压力、盆底肌力、盆腔脏器脱垂程度、压力性尿失禁发生率),采用盆底功能障碍治疗仪测定盆底肌表面肌电值(盆底肌表面肌电值快肌、慢肌肌力和慢肌耐力),同时采用视觉模拟评分法(Visual analogue scale,VAS)评价盆底筋膜疼痛程度。结果:观察组干预后压力性尿失禁发生率、阴道静息压力、盆腔脏器脱垂明显低于对照组,而盆底肌力评分明显高于对照组(P<0.05);观察组干预后快肌、慢肌肌力和慢肌耐力明显高于对照组(P<0.05);观察组干预后盆底筋膜VAS评分明显低于对照组(P<0.05)。结论:盆底肌锻炼结合生物反馈刺激可通过缓解产后盆底疼痛患者疼痛程度,提高盆底肌力,进而改善盆底功能。

Objective:To investigate the effects of pelvic floor exercise combined with biofeedback stimulation on the improvement of pelvic floor function and pain degree in postpartum pelvic floor pain.Methods:A total of 93 postpartum pelvic floor pain patients in our department from September 2018 to September 2019 were randomly divided into a control group(n=46)with biofeedback electrical stimulation at a frequency of 8~80 Hz.Pulse width:20~740μs)and observation group(n=47,increased in the control group on the basis of the pelvic floor muscle exercise),after 1 month,observe two groups of pelvic floor functional level(resting state of vaginal resting pressure,pelvic floor muscle strength,degree of pelvic organ prolapse and stress urinary incontinence rates),pelvic floor muscles,methods of electrical values(pelvic floor muscles methods of electrical values fast,slow muscle strength and muscle endurance)and the pelvic fascia pain degree were analyzed with visual analogue scale(VAS).Results:The incidence of stress urinary incontinence,vaginal resting pressure and pelvic organ prolapse after intervention in the observation group was significantly lower than that in the control group,and the pelvic floor muscle strength score was significantly higher than that in the control group(P<0.05).After intervention,the strength and endurance of fast and slow muscles in the observation group were significantly higher than those in the control group(P<0.05).After intervention,pelvic floor fascia VAS score in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Pelvic floor muscle exercise combined with biofeedback stimulation can improve pelvic floor muscle strength and function by relieving pain in postpartum pelvic floor patients.