盆底电生理检查在评估围绝经期和绝经后患者盆底脏器脱垂中的应用价值

Application Value of Pelvic Floor Electrophysiological Examination in the Evaluation of Pelvic Organ Prolapse in Perimenopausal and Postmenopausal Patients

目的:探讨盆底电生理检查在评估围绝经期和绝经后患者发生盆底脏器脱垂(POP)中的应用价值。方法:选取2023年1—6月江西省妇幼保健院收治的200例围绝经期和绝经后患者为研究对象,根据盆腔器官脱垂定量分期法评估结果将其分为POP组与非POP组,各100例。两组均开展盆底电生理检查,比较电生理参数异常率、POP与电生理参数关联性、诊断效能等。结果:两组的前静息测试阶段肌电变异性对比,差异无统计学意义(P>0.05);POP组前静息测试阶段肌电平均值、快肌测试阶段肌电上升时间与肌电下降时间、慢肌测试阶段肌电变异性、耐力测试阶段肌电变异性均高于非POP组,快肌测试阶段肌电最大值、慢肌测试阶段肌电最大值与肌电平均值、耐力测试阶段前10s肌电平均值与后10s肌电平均值、后静息测试阶段肌电平均值与肌电变异性均低于非POP组,差异均有统计学意义(P<0.05)。前静息测试阶段肌电平均值升高为POP的独立风险因素(P<0.05),诊断特异度为90.00%,灵敏度为95.00%,准确率为95.00%。结论:在围绝经期和绝经后患者评估POP中采用盆底电生理检查,可以实现患者盆底肌肉收缩能力的准确判断分析,具有较高的检测结果准确性与敏感性。

Objective:To evaluate the value of electrophysiological examination of pelvic floor in the assessment of pelvic floor organ prolapse(POP)in perimenopausal and postmenopausal patients.Methods:A total of 200 cases of perimenopausal and postmenopausal patients admitted to Jiangxi Provincial Maternal and Child Health Hospital from January to June 2023 were selected as the study objects.According to the quantitative staging evaluation results of pelvic organ prolapse,they were divided into POP group and non-POP group,with 100 cases each.Electrophysiological examination of pelvic floor was performed in both groups to compare the abnormal rate of electrophysiological parameters,the correlation between POP and electrophysiological parameters,and the diagnostic efficiency.Results:There was no significant difference in EMG variability between the two groups at the pre-resting test stage(P>0.05).The mean value of electromyography in the pre-resting test stage,the rise time and fall time of electromyography in the fast muscle test stage,the electromyography variability in the slow muscle test stage and the electromyography variability in the endurance test stage in the POP group were higher than those in the non-POP group.The maximum EMG value in the fast muscle test stage,the maximum EMG value and average EMG value in the slow muscle test stage,the average EMG value before and after the endurance test stage,and the average EMG variability in the post-rest test stage were lower than those in the non-POP group,and the differences were statistically significant(P<0.05).The increase of mean myoelectric value during pre-resting test was an independent risk factor for POP(P<0.05).Increased mean value of myoelectromyography in pre-resting test stage was an independent risk factor for POP(P<0.05),the diagnostic specificity,sensitivity and accuracy were 90.00%,95.00%and 95.00%respectively.Conclusion:The use of electrophysiological examination of pelvic floor in evaluating POP in perimenopausal and postmenopausal patients can accurately judge and analyze the contractile ability of pelvic floor muscles,has high accuracy and sensitivity of detection results.