盆底四维超声可评估电刺激生物反馈治疗女性盆底肌功能障碍患者的疗效

Four-dimensional pelvic floor ultrasound can evaluate the curative effect of electrical stimulation biofeedback in female patients with pelvic floor dysfunction

目的探讨基于盆底四维超声评估女性盆底肌功能障碍患者电刺激生物反馈治疗的疗效。方法选取2021年1月~2023年1月在我院收治的120例产后女性盆底肌功能障碍患者作为研究对象,所有患者均予以电刺激生物反馈治疗4个疗程,并在治疗前、治疗结束后行盆底四维超声检查。评估入组患者的临床疗效,比较治疗前、治疗后盆底肌力分级、1 h尿垫试验、盆底肌收缩压、四维超声参数(静息时、Valsalva动作时)、膀胱颈移动度和尿道旋转角,采用Pearson相关性分析治疗后膀胱颈移动度、尿道旋转角与盆底肌力分级、盆底肌收缩压的关系。结果120例患者经电刺激生物反馈治疗,总有效率为84.17%。治疗后盆底肌力分级、盆底肌收缩压比治疗前明显升高,1 h尿垫试验较之治疗前均明显下降,差异均有统计学意义(P<0.001)。治疗后肛提肌厚度(静息时、Valsalva动作时)较之治疗前均明显升高,肛提肌裂孔左右径、肛提肌裂孔面积、膀胱后角、膀胱颈移动度、尿道旋转角较之治疗前均明显下降,差异有统计学意义(P<0.001)。治疗后膀胱颈移动度与盆底肌力分级、盆底肌收缩压呈负相关关系(r=-0.746、-0.781,P<0.001);尿道旋转角与盆底肌力分级、盆底肌收缩压呈负相关关系(r=-0.779、-0.792,P<0.001)。结论经盆底四维超声可以较好评估盆底肌功能障碍患者电刺激生物反馈治疗前后盆底肌功能,值得临床推广。

Objective To evaluate the curative effect of electrical stimulation biofeedback in female patients with pelvic floor dysfunction(PFD)based on four-dimensional pelvic floor ultrasound.Methods A total of 120 female patients with postpartum PFD who underwent electrical stimulation biofeedback for 4 courses in the hospital were enrolled as the research objects from January 2021 to January 2023.All underwent four-dimensional pelvic floor ultrasound examination before and after treatment.The clinical curative effect was evaluated.The grading of pelvic floor muscle strength,1 h urine pad test,systolic blood pressure of pelvic floor muscle and four-dimensional ultrasound parameters(bladder neck movement and urethral rotation angle under rest and Valsalva maneuver state)were compared before and after treatment.The relationship between bladder neck movement,urethral rotation angle and grading of pelvic floor muscle strength,systolic blood pressure of pelvic floor muscle was analyzed by Pearson correlation analysis.Results In the 120 patients,total response rate of electrical stimulation biofeedback was 84.17%.After treatment,grading of pelvic floor muscle strength and systolic blood pressure of pelvic floor muscle were significantly increased,score of 1 h urine pad test was significantly decreased,the difference was statistically significant(P<0.001).After treatment,levator ani thickness(under rest and Valsalva maneuver state)was significantly increased,left-right diameter and area of levator hiatus,posterior bladder angle,bladder neck movement and urethral rotation angle were significantly decreased,the difference was statistically significant(P<0.001).After treatment,bladder neck movement was negatively correlated with grading of pelvic floor muscle strength and systolic blood pressure of pelvic floor muscle(r=-0.746,-0.781,P<0.001),and urethral rotation angle was also negatively correlated with them(r=-0.779,-0.792,P<0.001).Conclusion Four-dimensional pelvic floor ultrasound can better evaluate pelvic floor muscle function in PFD patients before and after electrical stimulation biofeedback.