生物反馈电刺激联合盆底肌康复训练在产后盆底功能障碍性疾病患者中的应用效果

Application effects of biofeedback electrical stimulation combined with pelvic floor muscle rehabilitation training in patients with postpartum pelvic floor dysfunction

目的:观察生物反馈电刺激联合盆底肌康复训练在产后盆底功能障碍性疾病(PFD)患者中的应用效果。方法:选取2021年6月至2023年6月该院收治的106例自然分娩产后PFD患者进行前瞻性研究,按照随机信封法将其分为对照组与研究组各53例。对照组进行盆底肌康复训练治疗,研究组在对照组基础上联合生物反馈电刺激治疗,比较两组临床疗效、治疗前后盆底肌力指标(快速收缩阶段最大值、紧张收缩阶段平均值、耐力收缩阶段平均值)水平、盆底功能指标[盆底功能障碍量表(PFDI)、阴道动态压力、阴道持续收缩时间]水平和尿失禁改善指标[腹压漏尿点压力(ALPP)、膀胱顺应性(BC)、最大尿道闭合压(MUCP)、国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF)]水平。结果:研究组治疗总有效率为96.23%(51/53),高于对照组的83.02%(44/53),差异有统计学意义(P<0.05);治疗后,研究组快速收缩阶段最大值、紧张收缩阶段平均值、耐力收缩阶段平均值均高于对照组,差异有统计学意义(P<0.05);治疗后,研究组PFDI评分低于对照组,阴道动态压力高于对照组,阴道持续收缩时间长于对照组,差异均有统计学意义(P<0.05);治疗后,研究组ICIQ-SF评分低于对照组,BC、MUCP、ALPP水平均高于对照组,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康复训练应用于产后PFD患者可提高治疗总有效率和盆底肌力指标水平,改善盆底功能指标和尿失禁改善指标水平,效果优于单纯盆底肌康复训练。

Objective:To observe application effects of biofeedback electrical stimulation combined with pelvic floor muscle rehabilitation training in patients with postpartum pelvic floor dysfunction(PFD).Methods:A prospective study was conducted on 106 patients with PFD after natural childbirth who were admitted to this hospital from June 2021 to June 2023.According to the random envelope method,they were divided into control group and study group,53 cases in each group.The control group was treated with pelvic floor muscle rehabilitation training,while the study group was treated with biofeedback electrical stimulation on the basis of that of the control group.The clinical efficacy,the pelvic floor muscle strength indexes(maximum value of rapid contraction stage,average value of tension contraction stage,average value of endurance contraction stage)levels,the pelvic floor function indexes[pelvic floor dysfunction scale(PFDI),vaginal dynamic pressure,vaginal continuous contraction time]levels,the urinary incontinence improvement indexes[abdominal leak point pressure(ALPP),bladder compliance(BC),maximum urethral closure pressure(MUCP),international consultation on in-continent questionnaire-short form(ICIQ-SF)]levels were compared between the two groups before and after the treatment.Results:The total effective rate of the study group was 96.23%(51/53),which was higher than the control group of 83.02%(44/53),and the difference was statistically significant(P<0.05).After the treatment,the maximum value of rapid contraction stage,the average value of tension contraction stage and the average value of endurance contraction stage in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the PFDI score of the study group was lower than that of the control group,the vaginal dynamic pressure was higher than that of the control group,the vaginal continuous contraction time was longer than that of the control group,and the differences were statistically significant(P<0.05).Further,after the treatment,the ICIQ-SF score of the study group was lower than that of the control group,the levels of BC,MUCP and ALPP were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusions:The biofeedback electrical stimulation combined with pelvic floor muscle rehabilitation training for the postpartum PFD patients can improve the total effective rate of treatment and the levels of pelvic floor muscle strength indexes and improve the levels of pelvic floor function indexes and urinary incontinence improvement indexes.Moreover,it is superior to simple pelvic floor muscle rehabilitation training.