摘要
目的:探究电刺激生物反馈对产后盆底功能障碍(pelvic floor dysfunctional disease,PFD)患者盆底肌力、盆底肌电位及基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶组织抑制因子-2(tissue inhibitor of metalloproteinase-2,TIMP-2)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)水平的影响。方法:选取2019年9月至2020年9月海南省妇女儿童医学中心收治的150例产后PFD患者,随机分为3组,每组各50例。其中A组给予Kegel盆底肌训练,B组给予电刺激生物反馈治疗,C组给予Kegel盆底肌训练联合电刺激生物反馈治疗,时间为3个月。对比3组临床疗效及治疗前后的盆底肌力、盆底肌电位、盆腔器官脱垂(pelvic organ prolapse,POP)-Q分期、性生活质量,并检测盆腔壁组织中MMP-2、TIMP-2、TGF-β1表达水平。结果:C组治疗总有效率为92.00%,高于A组(70.00%)和B组(76.00%),差异有统计学意义(P<0.05)。治疗后,C组盆底手测肌力及I类、II类纤维肌最大电位值均显著高于A组、B组(P<0.05),且B组显著高于A组(P<0.05)。治疗后,C组POP-Q分期等级与A组、B组相比明显降低(P<0.05),B组POP-Q分期等级与A组相比,差异无统计学意义(P>0.05)。治疗后,A组、B组、C组盆腔器官脱垂-尿失禁性功能问卷(Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire-12,PISQ-12)评分分别为26.34±5.67、28.96±5.31、32.88±5.29,差异有统计学意义(P<0.05)。治疗后,C组MMP-2水平显著低于A组、B组(P<0.05),TIMP-2、TGF-β1水平显著高于A组、B组(P<0.05),且B组各指标变化优于A组(P<0.05)。结论:电刺激生物反馈治疗产后PFD疗效显著,能够增强患者盆底肌力,改善患者性生活质量。
Objective:To explore the effects of electrical stimulation biofeedback on pelvic floor muscle strength,pelvic floor muscle potential,matrix metalloproteinase-2(MMP-2),tissue inhibitor of matrix metalloproteinase-2(TIMP-2)and transforming growth factor-β1(TGF-β1)in patients with postpartum pelvic floor dysfunction(PFD).Methods:A total of 150 postpartum PFD patients admitted to Hainan Women and Children’s Medical Center from September 2019 to September 2020 were randomly divided into 3 groups with 50 patients in each group.The A group was given Kegel pelvic floor muscle training,the B group was given electrical stimulation biofeedback therapy,and the C group was given Kegel pelvic floor muscle training combined with electrical stimulation biofeedback therapy for 3 months.The clinical efficacy,pelvic floor muscle strength,pelvic floor muscle potential,pelvic organ prolapses(POP)-Q stage,quality of sexual life,and the expression levels of MMP-2,TIMP-2 and TGF-β1 in pelvic wall tissue were compared between the two groups before and after treatment.Results:The total effective rate of the C group was 92.00%,higher than that of group A(70.00%)and group B(76.00%),and the difference was statistically significant(P<0.05).After treatment,the pelvic floor muscle strength measured by hand and the maximum potential values of class I and class II fibromuscular in the C group were significantly higher than those in the A and B group(P<0.05),and that in B group was significantly higher than that in A group(P<0.05).After treatment,the POP-Q staging grade of the C group was significantly lower than that of the A group and B group(P<0.05),and there was no difference in POP-Q staging grade between B group and A group(P>0.05).After treatment,the scores of Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire-12(PISQ-12)in the A group,B group and C group were 26.34±5.67,28.96±5.31,32.88±5.29,respectively,and the difference was statistically significant(P<0.05).After treatment,the level of MMP-2 in the C group was significantly lower than that in the A group and B group(P<0.05),and the levels of TIMP-2 and TGF-β1 in the C group were significantly higher than those in the A group and B group(P<0.05),and the changes of indexes in B group were better than those in A group(P<0.05).Conclusion:Electrical stimulation biofeedback is effective in the treatment of postpartum PFD,which can enhance the pelvic floor muscle strength and improve the quality of sexual life.
作者
曾小丹
李常虹
张春雨
ZENG Xiaodan;LI Changhong;ZHANG Chunyu(Department of Obstetrics,Women and Children Medical Center of Hainan Province,Haikou 570206;Department of Women’s Health,Women and Children Medical Center of Hainan Province,Haikou 570206,China)
出处
《临床与病理杂志》
CAS
2022年第1期88-95,共8页
Journal of Clinical and Pathological Research
基金
海南省医药卫生科研项目(20A200187)。