腹横肌与盆底肌联合收缩训练对全子宫切除术后患者盆腔功能和性生活质量的影响

Effect of combined contraction training of transverse abdominal muscle and pelvic floor muscle on pelvic function and sexual life quality of patients after total hysterectomy

目的观察不稳定坐位下腹横肌与盆底肌联合收缩训练对全子宫切除术(TH)后压力性尿失禁(SUI)患者盆底肌、性功能的改善程度。方法选取2018年3月至2022年3月于儋州市人民医院治疗的TH术后发生SUI的119例患者作为研究对象,根据数字随机法将患者分为观察组(n=59)与对照组(n=60)。对照组接受常规盆底肌训练(PFMT),观察组行腹横肌与盆底肌联合收缩训练。观察两组患者Ⅰ类肌、Ⅱ类肌的收缩力度,并采用盆底功能障碍问卷(PFDI-20)、女性性功能量表(FSFI)对患者进行评估。结果两组患者经训练后Ⅰ类肌、Ⅱ类肌最大肌电值力均较治疗前有显著性提高(P<0.05),而观察组患者治疗后的I类肌肌电值显著高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后PFDI-20评分均显著下降(P<0.05),且观察组下降程度显著高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者FSFI各项评分均呈显著上升趋势(P<0.05),且观察组FSFI评分显著高于对照组,差异具有统计学意义(P<0.05)。结论相较于常规PFMT,不稳定坐位下腹横肌与盆底肌的联合收缩训练对全子宫切除术后SUI患者的盆底肌功能、性功能改善效果显著。

Objective To observe the improvement of pelvic floor muscle and sexual function in patients with stress urinary incontinence(SUI)patients after total hysterectomy(TH)under combined contraction training of transverse abdominal muscle and pelvic floor muscle in unstable sitting position.Methods 119 patients with SUI after TH who were treated in Danzhou People′s Hospital from March 2018 to March 2022 were selected as the study subjects.According to the numerical randomization method,the patients were divided into the observation group(n=59)and the control group(n=60).The control group were given routine pelvic floor muscle training(PFMT).The observation group were given combined contraction training of transverse abdominal muscle and pelvic floor muscle.The contractile strength of classⅠand classⅡmuscles of the two groups was recorded,and the pelvic floor dysfunction inventory(PFDI-20)and female sexual function index(FSFI)were used to evaluate the patients.Results After training,the maximum electromyogram(EMG)force of classⅠmuscle and classⅡmuscle in the two groups were significantly increased compared with that before treatment(P<0.05),while the maximum EMG force of classⅠmuscle in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).After treatment,the scores of PFDI-20 in the two groups decreased significantly(P<0.05),and the value in the observation group was better than that in the control group,with a statistically significant difference(P<0.05).Besides,the FSFI scores of the two groups showed a significant upward trend after treatment(P<0.05),and observation group′s FSFI score after treatment was significantly better than that of the control group(P<0.05).Conclusions Compared with conventional PFMT,the combined contraction training of transverse abdominal muscle and pelvic floor muscle in unstable sitting position is more effective in improving the pelvic floor muscle function and sexual function of SUI patients after total hysterectomy.