经阴道电刺激及生物反馈联合阴道哑铃Kegel锻炼对产后阴道前壁脱垂患者盆底功能恢复效果

Effect of the pelvic floor function recovery of the transvaginal electrical stimulation and biofeedback training combined with vaginal dumbbell Kegel exercise for treating patients with postpartum anterior vaginal prolapse

目的:探究经阴道电刺激及生物反馈联合阴道哑铃Kegel锻炼治疗产后阴道前壁脱垂效果,对患者盆底肌电生理指标、盆腔器官脱垂定量(POP-Q)评分的影响。方法:选取2019年11月-2021年11月本院接诊的135例产后阴道前壁脱垂患者,简单随机化法分为观察组68例和对照组67例,两组均采用阴道哑铃Kegel锻炼治疗,观察组联合阴道电刺激及生物反馈,持续治疗2个月。比较两组治疗前、治疗2个月后盆底肌电生理指标(I类肌纤维疲劳度、Ⅰ类肌纤维肌电值、Ⅱ类肌纤维疲劳度、Ⅱ类肌纤维肌电值)、膀胱功能[初始尿意膀胱容量(FVS)、最大尿意膀胱容量(MVS)、排尿后残余尿量(PVR)]、阴道前壁脱垂情况[盆腔器官脱垂定量评分表(POP-Q)]、生活质量[盆底功能影响评分(PFIQ-7)]的变化。结果:治疗2个月后,两组I类肌纤维疲劳度、I类肌纤维肌电值、Ⅱ类肌纤维疲劳度、Ⅱ类肌纤维肌电值、FVS、MVS均提高,且观察组高于对照组;两组PVR、PFIQ-7评分均降低,且观察组(5.29±1.76ml、42.38±10.65分)低于对照组(7.88±2.13ml、65.30±14.25分)(均P<0.05)。结论:阴道电刺激及生物反馈联合阴道哑铃Kegel锻炼能显著提高产后阴道前壁脱垂患者盆底肌收缩功能,对患者预后有利。

Objective:To explore the ffect of the pelvic floor function recovery of the transvaginal lctrical stimulation and biofeedback training combined with vaginal dumbbell Kegel exercise for treating patients with postpartum anterior vaginal prolapse,and to study these treatments on the pelvic floor eletrophysiological indicators and the pelvic organ prolapse quantitation(POP-Q)score of these patients.Methods:Totally 135 patients with postpartum anterior vaginal prolapse were selected and were divided into two groups by the simple randomization method from November 2019 to November 2021.68 patients in the observation were given the treatment of pelvic floor function recovery of the trans-vaginal electrical stimulation and biofeedback training combined with vaginal dumbbell Kegel exercise,and 67 patients in the control group were given the treatment of vaginal dumbbell Kegel exercise alone.The changes of the pelvic floor electropbysiological indicators,such as fatigue degree and electromyography value of the type Ⅰ muscle fiber and type Ⅱ musele fiber,the bladder funection indexes,such as first bladder volume(FVS),maximum bladder volume(MVS),and post voiding residual volume(PVR),the anterior vaginal prolapse situation evalued by POP Q,and the quality of lifte evalued by pelvic floor impact questionnaire-7(PFIQ-7)of the patients before treatment and after 2 months of treatment were compared between the two groups.Results:After 2 months of treatment,the fatigue degree and elec-tromyography walue of the type I muscle fiber and the type II muscle fiber,and the values of FVS,MVS of the patients in both groups had increased significantly,and which of the patients in the observation group were significantly higher than those of the patients in the control group.The PVR value and the PFIQ-7 score of the patients in both groups had decreased significantly,and which(5.29±1.76ml and 42.38±10.65 points)of the patients in the observation group were significantly lower than those(7.88±2.13ml and 65.30±14.25 points)of the patients in the control group(all P<0.05).Conclusion:Vaginal electrical stimulation and biofeedback training combined with vaginal dumbbell Kegel ex-ercise for treating patients with postpartum anterior vaginal prolapse can significantly improve their contraction func-tion of pelvic floor muscle,and which is beneficial to the prognosis of the patients.