不同电刺激方案对弱肌力相关女性松弛型盆底功能障碍的短期疗效研究

Study on the short-term curative effect of different electrical stimulation schemes on women with weak muscle strength-related loose pelvic floor dysfunction

目的探讨不同电刺激方案对弱肌力相关女性松弛型盆底功能障碍的短期疗效研究。方法回顾性选取2020年3月至2021年3月同济大学附属第一妇婴保健院收治的弱肌力相关女性盆底功能障碍(FPFD)患者116例为研究对象,按照治疗方式的不同分为A组(n=32)、B组(n=39)和C组(n=45),A组采用电刺激治疗,B组采用电刺激联合生物反馈治疗,C组采用电刺激联合生物反馈治疗的同时配合Kegel训练。比较3组患者盆底肌肉表面肌电值、盆底功能障碍评估[国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)、盆底障碍影响简易问卷7(PFIQ-7)、盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12)评分]和盆腔器官脱垂情况。结果治疗后,3组患者的静息阶段、快肌放松时间、后静息阶段值均明显低于治疗前,快肌最大值、10 s慢肌阶段、60 s慢肌阶段均显著高于治疗前,差异均有统计学意义(P<0.05);C组10 s慢肌阶段、60 s慢肌阶段值显著高于B组和A组,B组10 s慢肌阶段、60 s慢肌阶段的值显著高于A组,差异均有统计学意义(P<0.05)。C组的ICI-Q-LF、PFIQ-7评分明显低于B组和A组,B组的ICI-Q-LF、PFIQ-7评分明显低于A组,差异均有统计学意义(P<0.05);C组的PISQ-12评分明显高于B组和A组,B组的PISQ-12评分明显高于A组,差异均有统计学意义(P<0.05)。C组的盆腔器官脱垂情况明显优于B组和A组,B组盆腔器官脱垂情况明显优于A组,差异均有统计学意义(P<0.05)。结论不同电刺激方案在短期内均能够改善弱肌力相关女性松弛型盆底功能障碍患者的盆底肌力电位、压力性尿失禁和盆腔器官脱垂情况,可有效促进患者盆底功能恢复,尤其是联合联合生物反馈治疗的同时配合Kegel训练方案效果最佳。

Objective To investigate the short-term effects of different electrical stimulation programs on women with weak muscle strength-related laxative pelvic floor dysfunction.Methods A retrospective selection of 116 patients with weak muscle strength related female pelvic floor dysfunction(FPFD)treated in the first maternal and child health care hospital affiliated to Tongji University from March 2020 to March 2021,According to the different treatment methods,they were divided into group A(n=32),group B(n=39)and group C(n=45).Group A was treated with electrical stimulation,group B was treated with electrical stimulation and biofeedback,and group C was treated with electrical stimulation and biofeedback combined with Kegel training.The surface EMG value of pelvic floor muscle,pelvic floor dysfunction evaluation[International Urinary Incontinence Advisory Committee Urinary Incontinence Questionnaire Short Form(ICI-Q-LF),pelvic floor disorder effects simple questionnaire 7(PFIQ-7)Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire(PISQ-12)score],stress urinary incontinence and pelvic organ prolapse were compared among the three groups.Results After treatment,the values of resting stage,fast muscle relaxation time and post resting stage in the three groups were significantly lower than those before treatment,and the maximum value of fast muscle,10 s slow muscle stage and 60 s slow muscle stage were significantly higher than those before treatment,the differences were statistically significant(P<0.05);after treatment,the value of the 10 s slow muscle stage and 60 s slow muscle stage in the electrical group C were significantly higher than that of the group B and group A,10 s slow muscle stage and 60 s slow muscle stage values in group B were significantly higher than the group A,the differences were statistically significant(P<0.05).ICI-Q-LF,PFIQ-7 scores of the group C were significantly lower than those of the group B and group A,the ICI-Q-LF,PFIQ-7 scores of the group B were significantly lower than thoseof the electrical stimulation group A,the differences were statistically significant(P<0.05);the PISQ-12 scores of the group C were significantly higher than those of the group B and the group A,and the PISQ-12 score of the group B were significantly higher than the group A,the differences were statistically significant(P<0.05).The pelvic organ prolapse in the group C was significantly better than the group B and the group A,the pelvic organ prolapse of the group B was significantly better than that of the group A,the differences were statistically significant,the differences were statistically significant(P<0.05).Conclusion Different electrical stimulation schemes can improve the pelvic floor muscle strength potential,stress urinary incontinence and pelvic organ prolapse of pelvic floor relaxation related dysfunction in women with loose pelvic floor dysfunction in a short time,and can effectively promote the recovery of pelvic floor function,especially combined with biofeedback treatment and Kegel training scheme.