摘要
目的:探讨体外磁波盆底治疗联合盆底肌训练对不同分娩方式产后盆底功能障碍效果。方法:选择2020年1月至2022年1月我院产后6~8周复查的盆底功能障碍性疾病患者共120例,其中经阴道分娩60例,剖宫产60例,入选者随机分为对照组(经阴道分娩对照A组、剖宫产对照B组)、实验组(经阴道分娩实验A组、剖宫产实验B组)。对照组给予盆底肌训练,实验组给予盆底肌训练+体外磁波盆底治疗,治疗前后各组分别比较临床疗效、盆底肌电Glazer评估、盆底功能障碍问卷(PFDI-20)、盆底障碍影响简易问卷(PFIQ-7)变化情况及临床并发症发生情况。结果:治疗后,实验A组和实验B组临床疗效比较无显著差异;实验A组和实验B组总有效率均显著高于对照A组和对照B组,差异显著(χ^(2)=14.471,P<0.05);治疗前,各组之间快肌收缩最大值、10s慢肌收缩平均值及60s慢肌收缩平均值比较无显著差异;治疗后,各组快肌收缩最大值、10s慢肌收缩平均值及60s慢肌收缩平均值均显著升高,且实验A组和实验B组高于对照A组和对照B组,差异显著(t=3.629,4.983,4.991,3.774,5.199,4.669,P<0.05),且实验A组在10s慢肌收缩平均值及60s慢肌收缩平均值增加高于实验B组;治疗前对照B组和实验B组前、后静息肌张力较对照A组和实验A组高,经治疗后,实验B组前后静息盆底肌张力明显降低,其余各组变化不大;治疗前,各组之间PFIQ-7、PFDI-20评分比较无显著差异;治疗后,各组PFIQ-7、PFDI-20评分均显著降低,且实验A组和实验B组分别低于对照A组和对照B组,差异显著(P<0.05);治疗前,各组之间压力性尿失禁等并发症总发生率比较无显著差异;治疗后,实验A组和实验B组压力性尿失禁等并发症总发生率均显著低于对照A组和对照B组,差异显著(χ^(2)=9.629,11.193,P<0.05)。结论:体外磁波盆底治疗联合盆底肌训练治疗不同分娩方式产妇盆底功能障碍均能取得显著的效果,且均优于单独盆底肌训练,且阴道分娩产妇盆底功能障碍恢复情况优于剖宫产产妇。
Objective:To study the effectiveness of extracorporeal magnetic wave pelvic floor therapy combined with pelvic floor muscle training on postpartum pelvic floor dysfunction in different delivery modes.Methods:A total of 120 patients with pelvic floor dysfunctional disorders who were reviewed at 6-8 weeks postpartum in our hospital from January 2020 to January 2022,including 60 vaginal deliveries and 60 cesarean deliveries,were selected and randomly divided into control group(vaginal delivery control group A and cesarean delivery control group B)and experimental group(vaginal delivery experimental group A and cesarean delivery experimental group B).The control group was given pelvic floor muscle training and the experimental group was given pelvic floor muscle training+extracorporeal magnetic wave pelvic floor therapy.Before and after treatment,each group was compared in terms of the clinical efficacy,pelvic floor electromyography Glazer assessment,Pelvic Floor Dysfunction Questionnaire(PFDI-20),Pelvic Floor Impact Questionnaire(PFIQ-7)and clinical complications.Results:After treatment,there was no significant difference between the clinical efficacy of experimental group A and experimental group B;the total effective rate of both experimental group A and experimental group B was significantly higher than that of control group A and control group B.The difference was significant(χ^(2)=14.471,P<0.05).Before treatment,there was no significant difference in the comparison of the maximum value of fast muscle contraction,the mean value of 10s slow muscle contraction and the mean value of 60s slow muscle contraction between the groups;after treatment,the maximum value of fast muscle contraction,the mean value of 10s slow muscle contraction and the mean value of 60s slow muscle contraction were significantly higher in each group,and the difference was higher in experimental group A and experimental group B than in control group A and control group B.The difference was significant(t=3.629,4.983,4.991,3.774,5.199,4.669,P<0.05),and the increase in the mean 10s slow muscle contraction and the mean 60s slow muscle contraction was higher in the experimental group A than in the experimental group B.Before treatment,the pre and post resting muscle tension was higher in control group B and experimental group B than in control group A and experimental group A.After treatment,the pre and post resting pelvic floor muscle tension was significantly lower in experimental group B,while the remaining groups did not change significantly;before treatment,there was no significant difference in the comparison of PFIQ-7 and PFDI-20 scores between the groups;after treatment,the PFIQ-7 and PFDI-20 scores were significantly lower in all groups,and experimental group A and experimental group B had lower scores than control group A and control group B respectively,with significant differences(P<0.05).Before treatment,there was no significant difference in the total incidence of complications such as stress urinary incontinence between the groups;after treatment,the total incidence of complications such as stress urinary incontinence was significantly lower in both experimental group A and experimental group B than in control group A and control group B.The difference was significant(χ^(2)=9.629,11.193,P<0.05).Conclusion:The combination of extracorporeal magnetic pelvic floor therapy and pelvic floor muscle training achieved significant results in treating pelvic floor dysfunction in women with different modes of delivery,all of which were better than pelvic floor muscle training alone,and the recovery of pelvic floor dysfunction was better in women who delivered vaginally than in those who delivered by caesarean delivery.
作者
马黎黎
陈伟
张明
周敬杰
于丹
袁梦
姚瑶
杨洋
乔书韵
MA Lili;CHEN Wei;ZHANG Ming(Xuzhou Clinical College,Xuzhou Medical University/Xuzhou Central Hospital,Jiangsu Xuzhou 221009,China)
出处
《河北医学》
CAS
2022年第7期1152-1157,共6页
Hebei Medicine
基金
江苏省徐州市国家临床重点专科培育项目,(编号:2018ZK002)。
关键词
体外磁波盆底治疗
盆底肌训练
不同分娩方式
产后
盆底功能障碍
Extracorporeal magnetic wave pelvic floor therapy
Pelvic floor muscle training
Different delivery modes
Postpartum
Pelvic floor dysfunction