会阴裂伤修补术并盆底康复治疗陈旧性会阴撕裂效果

Efficacy of surgical repair combined with pelvic floor rehabilitation in treatment of old perineal laceration

目的探究会阴裂伤修补术并盆底康复对Ⅲ/Ⅳ度会阴撕裂病人的临床疗效。方法选取2020年8月—2022年2月宁夏回族自治区人民医院收治的Ⅲ/Ⅳ度会阴撕裂病人106例,随机分为联合治疗组和单纯手术组,每组53例。单纯手术组仅接受会阴裂伤修补术,联合治疗组于会阴裂伤修补术后行盆底康复治疗。比较两组临床疗效、肛门功能、盆底肌损伤指标和生活质量。结果联合治疗组总有效率为92.45%,明显高于单纯手术组的81.13%,差异有显著性(Z=1.995,P<0.05)。两组病人治疗后Ⅰ类肌纤维活动持续时间、Ⅱ类肌纤维收缩次数以及盆底肌疲劳程度均显著改善(t=4.218~7.818,P<0.05),但联合治疗组的改善程度显著高于对照组(t=4.876~5.870,P<0.05)。联合治疗组的术后生活质量量表评分和肛门功能良好率均显著高于单纯手术组(t=14.552~21.348,Z=2.003,P<0.05)。结论会阴裂伤修补术并盆底康复治疗陈旧性Ⅲ/Ⅳ度会阴撕裂病人有较好疗效,能改善病人的盆底肌和肛门功能,提高病人生活质量。

Objective To investigate the clinical efficacy of surgical repair combined with pelvic floor rehabilitation in the treatment of gradeⅢ/Ⅳperineal laceration.Methods A total of 106 patients with gradeⅢ/Ⅳperineal laceration who were admitted to The People’s Hospital of Ningxia Hui Autonomous Region from August 2020 to February 2022 were enrolled and randomly divided into combined treatment group and simple surgery group,with 53 patients in each group.The patients in the simple surgery group received surgical repair of perineal laceration alone,and those in the combined treatment group received pelvic floor rehabilitation after surgical repair of perineal laceration.The two groups were compared in terms of clinical outcome,anal function,pelvic floor muscle injury,and quality of life.Results The combined treatment group had a significantly higher overall response rate than the simple surgery group(92.45%vs 81.13%,Z=1.995,P<0.05).After treatment,both groups had significant improvements in the duration of typeⅠmuscle fiber activity,the number of typeⅡmuscle fiber contractions,and the degree of pelvic floor muscle fatigue(t=4.218-7.818,P<0.05),and the combined treatment group had significantly greater improvements than the control group(t=4.876-5.870,P<0.05).Compared with the simple surgery group,the combined treatment group had significantly higher quality of life score and good rate of anal function after surgery(t=14.552-21.348,Z=2.003,P<0.05).Conclusion Surgical repair combined with pelvic floor rehabilitation has a good clinical effect in patients with gradeⅢ/Ⅳold perineal laceration and can improve pelvic floor muscle function,anal function,and quality of life.