生物反馈电刺激及盆底肌锻炼对产后不同时期女性盆腔器官脱垂恢复的影响

Effects of biofeedback electrical stimulation and pelvic floor muscle exercise on the recovery of pelvic organ prolapse in women at different postpartum periods

目的:分析盆底肌锻炼联合生物反馈电刺激对产后不同时期女性盆底肌功能恢复的治疗效果。方法:采用回顾性分析,选取2020年9月~2021年11月我院康复科门诊收治的39例轻度盆腔器官脱垂产妇作为研究对象。根据治疗开始时间将产妇分为早期组(产后45天内)24例和晚期组(产后3个月及以上)15例。所有产妇均接受同样的盆底康复治疗,即盆底生物反馈电刺激、呼吸训练和凯格尔运动。通过分析治疗前后盆底表面肌电、三维盆底超声检查结果,比较康复治疗对2组产妇盆底功能恢复的影响。结果:通过8周的盆底康复治疗,2组产妇盆底肌慢肌平均值、耐力平均值升高(均P<0.05),2组产妇盆底肌慢肌得分、耐力得分、总得分均升高(均P<0.05),早期组快肌得分、耐力得分、总得分改善幅度大于晚期组(均P<0.05)。2组产妇的肛提肌裂口面积均缩小(均P<0.05)。早期组产妇的膀胱颈位置升高,膀胱颈移动度缩小,膀胱后角减小(均P<0.05),早期组的膀胱颈移动度改善幅度明显大于晚期组(P<0.05)。结论:产后早期进行生物刺激反馈仪联合盆底肌锻炼可更加有效地增强其产后盆底肌的肌力与耐力,改善盆底器官脱垂程度,治疗效果较为理想,值得临床推广应用。

Objective:To objectively analyze the therapeutic effect of pelvic floor muscle exercise combined with bio feedback electrical stimulation on the recovery of pelvic floor muscle function in women in different postpartum periods.Methods:A total of 39 women with mild pelvic organ prolapse were admitted from September 2020 to November 2021 in the rehabilitation outpatient clinic.The patients were divided into the early group(within 45 days after delivery)and the late group(3 months after delivery)according to the starting treatment time.All women received the same pelvic floor rehabilitation therapy.By analyzing the results of pelvic floor surface electromyography and three-dimensional pelvic floor ultrasonography before and after treatment,the effects of rehabilitation therapy on the recovery of pelvic floor function of the two groups were compared.Results:After 8 weeks of pelvic floor rehabilitation,the mean of slow muscle and endurance of the pelvic floor muscles of the two groups were increased(all P<0.05).The scores of slow muscles,endurance scores and total scores of pelvic floor muscles were increased in the two groups(all P<0.05).The improvement of type II muscle score,endurance score,and total score in the early group was significantly greater than in the late group,and the difference was statistically significant.After the intervention,while the patients performed Valsalva,the improvement of bladder neck mobility in the early group was greater than in the late group,and the difference was statistically significant(P<0.05).The area of the levator hiatus decreased in both groups(both P<0.05).In the early group,when the patients performed Valsalva,the position of the bladder neck was significantly higher than that before treatment,while the mobility of the bladder neck and the posterior angle of the bladder were statistically reduced compared with those before treatment(P<0.05).Conclusion:Early postpartum biofeedback electrical stimulation combined with pelvic floor muscle rehabilitation can more effectively enhance the postpartum pelvic floor muscle strength and endurance,improve the degree of pelvic floor organ prolapse,and the therapeutic effect is ideal,which is worthy of clinical application.