磁电联合综合盆底康复治疗对盆底松弛患者的疗效观察

Efficacy of combined treatment with magnetic and electrical stimulation as a comprehensive rehabilitation therapy for patients with pelvic floor relaxation

目的探讨磁电联合综合盆底康复治疗对盆底松弛患者的临床疗效。方法选择2019年8月1日至2021年4月30日在中国航天科工集团七三一医院妇产科门诊诊断为盆底松弛的292例患者为研究对象,以挂号序号随机分为观察组147例(磁电联合组)和对照组145例(电刺激组),2组患者均进行家庭训练,治疗前后行Glazer评估,前瞻性研究盆底表面肌电值以及盆底肌力变化情况,评估2组治疗的临床效果。结果(1)盆底表面肌电值:与治疗前比较,2组治疗后前静息平均值、紧张收缩平均值、耐力收缩平均值方面均明显改善(P均<0.05),观察组患者治疗后快速收缩最大值提高,差异有统计学意义(P<0.05),对照组治疗前后快速收缩最大值差异无统计学意义(P>0.05);观察组治疗后快速收缩最大值变化幅度大于对照组,差异有统计学意义(P<0.05),2组间前静息平均值、紧张收缩平均值、耐力收缩平均值、后静息平均值变化差异无统计学意义(P均>0.05)。(2)临床疗效比较:观察组治疗后盆底肌力总有效率为76.87%,其中显效占比39.82%;对照组治疗后盆底肌力总有效率为73.10%,其中显效占比20.75%;2组比较,治疗总有效率差异无统计学意义(P>0.05),但显效占比差异有统计学意义(P<0.05)。结论磁电联合综合治疗和电刺激治疗均可改善盆底松弛患者的盆底肌力,磁电联合综合治疗对快肌纤维快速收缩力的提升优于单纯电刺激治疗,且显效率更高,值得推广。

Objective To evaluate the clinical efficacy of combined treatment with magnetic and electrical stimulation as a comprehensive rehabilitation therapy for patients with pelvic floor relaxation.Methods A total of 292 patients diagnosed with pelvic floor relaxation at the Department of Obstetrics and Gynecology of China Aerospace Science and Industry Corporation 731 Hospital from August 1,2019 to April 30,2021 were included in this study.Among these patients,147 were randomly selected into an observation group(combined treatment with magnetic and electrical stimulation),and the other 145 cases were assigned to a control group(electrical stimulation treatment)according to the registered number.Both groups of patients conducted home training and received Glazer assessment before and after treatment to observe changes in the surface electromyography(sEMG)of the pelvic floor muscles(PFMs)in order to evaluate the clinical efficacy.Results Compared with the values before treatment,the sEMS measurements were improved in both groups after treatment in terms of the pre-resting average value,the tension contraction average value,and the endurance contraction average value(P<0.05 each).For the observation group,the maximum value of fast muscle contraction significantly increased after treatment(P<0.05),while the control group had no statistical change(P>0.05).After treatment,the rangeability of the maximum value of fast muscle contraction in the observation group was significantly larger than that of the control group(P<0.05),while there was no significant difference in the pre-resting average value,tension contraction average value,endurance contraction average value,and post-resting average value between the two groups after treatment(P>0.05 each).The total effective rate of improving pelvic floor muscle strength after treatment in the observation group was 76.87%,with 39.82%showing marked improvement.The total effective rate of improving pelvic floor muscle strength after treatment in the control group was 73.10%,with 20.75%showing marked improvement.There was no statistically significant difference in the total effective rate of treatment between the two groups(P>0.05),but the difference in the rate of marked improvement was statistically significant(P<0.05).Conclusion Combined treatment with magnetic and electrical stimulation and pure electrostimulation treatment both can improve the pelvic floor muscle function of patients with pelvic floor relaxation.Combined treatment has better results in improving the fast muscle contraction,is a more effective therapy,and it is worthy of promotion.