生物反馈电刺激联合盆底肌训练在阴道分娩产妇产后盆底功能康复中的应用效果

Application effects of biofeedback electric stimulation combined with pelvic floor muscle training in puerperal pelvic floor function rehabilitation

目的:观察生物反馈电刺激联合盆底肌训练在阴道分娩产妇产后盆底功能康复中的应用效果。方法:选取2020年2月至2021年7月该院收治的146例阴道分娩产妇进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各73例。对照组给予盆底肌训练干预,观察组在对照组基础上联合生物反馈电刺激干预,比较两组干预前后盆底肌肌纤维指标水平、盆底功能障碍发生率、尿失禁发生率和生命质量评分。结果:干预后,观察组Ⅰ、Ⅱ类肌纤维疲劳水平均低于对照组,慢肌平均肌电、后静息平均肌电、前静息平均肌电、阴道动态压力、快肌最大肌电水平均高于对照组,差异有统计学意义(P<0.05);观察组盆底功能障碍发生率、尿失禁发生率均低于对照组,差异有统计学意义(P<0.05);观察组行为限制、社会障碍及心理影响等维度生命质量评分均高于对照组,差异有统计学意义(P<0.05)。结论:生物反馈电刺激联合盆底肌训练应用于阴道分娩产妇产后盆底功能康复可提高生命质量评分,改善盆底肌肌纤维指标水平,以及降低盆底功能障碍发生率和尿失禁发生率,优于单纯盆底肌训练效果。

Objective: To observe application effects of biofeedback electric stimulation combined with pelvic floor muscle training in puerperal pelvic floor function rehabilitation. Methods: A prospective study was conducted on 146 puerperas admitted to the hospital from February 2020 to July 2021. They were divided into control group and observation group according to the random number table method, 73 cases in each. The control group was given pelvic floor muscle training intervention, while the observation group was combined with biofeedback electric stimulation intervention on the basis of that of the control group. The levels of pelvic floor muscle fiber indexes, the incidence of pelvic floor dysfunction and urinary incontinence, and the quality of life score were compared between the two groups before and after the intervention. Results: After the intervention, the fatigue levels of type I and II muscle fibers in the observation group were lower than those in the control group;the average EMG of slow muscle, the average post-rest EMG, the average pre-rest EMG, the dynamic vaginal pressure and the maximum EMG of fast muscle were higher than those in the control group;and the differences were statistically significant(P<0.05). The incidence of pelvic floor dysfunction and urinary incontinence in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). Further,the quality of life scores of behavior restriction, social disorder and psychological influence in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). Conclusions: Biofeedback electric stimulation combined with pelvic floor muscle training can improve the quality of life score, improve the levels of pelvic floor muscle fiber indexes, and reduce the incidence of pelvic floor dysfunction and urinary incontinence. Moreover, it is superior to single pelvic floor muscle training.