Effects of High Risk Pregnancy Factors on Pelvic Floor Muscle Weakness and Changes of PG, ACTH and CRP

Objective: To investigate the effects of different delivery modes on perinatal pelvic floor muscle strength, PG, ACTH and CRP of high-risk pregnant women. Methods: 380 high-risk pregnant women who gave birth in our hospital from March 2021 to February 2022 were selected as subjects, including 100 vaginal natural delivery, 156 forceps assisted delivery and 124 cesarean section. Pelvic floor pressure, PG, ACTH, CRP, IL-6, TNF-α and IL-4, IL-10 levels were evaluated and compared. The perinatal occurrence of pelvic floor functional disease (PFD) in high-risk pregnant women in each group was analyzed and evaluated. Results: There were statistical differences in the amount of postpartum blood loss (P 0.0001, F = 99.01), postpartum blood loss 24 h (P = 0.0004, F = 19.54) and hospital stay (P 0.0001, F = 70.81) among the three groups of high-risk women in natural vaginal delivery, forceps delivery and cesarean section. In addition, there were 72, 134 and 70 cases of abnormal pelvic floor fatigue in natural vaginal delivery, forceps assisted delivery and cesarean section (P 0.0001, χ2 = 30.16). There were 36, 79 and 21 cases of muscle injury, respectively (P 0.0001, χ2 = 34.16). There were 49, 98 and 43 cases of dysmuscular contraction, respectively (P 0.0001, χ2 = 21.94). There were 65, 120 and 41 cases with vaginal dynamic pressure 80 cm H2O (P 0.0001, χ2 = 56.86), respectively. The.

A nurse-led long-term pelvic floor muscle training program in the management of female patients with overactive bladder e A study protocol for a randomized controlled trial

Background:Previous research has suggested that pelvic floor muscle training(PFMT)offers a therapeutic benefit in patients with overactive bladder.Methods:Weconducted a single-blind,randomized trial of pelvic floor muscle training(PFMT)as compared with usual care.The intervention group(n=54)received a 6-month a nurse-led long-term pelvic floor muscle training program(three sessions a day,15e20 times per session)and the control group(n?53)received usual care.All patients received 3-month solifenacin succinate tablets(5 mg e once daily).The treatment outcomes were measured by the Modified Oxford Scale(MOS),Overactive Bladder SymptomScore(OABSS)and the King's Health Questionnaire(KHQ)at baseline,3 months and 6 months respectively.Results:Of the 91 randomly assigned patients,46 patients in the PFMT group and 45 patients in the control group completed the trial.The trial revealed statistically significant differences between groups in pelvic muscle strength at 3 months following the intervention(p<0.05),but no significant difference was found between two groups in OABSS scores(p>0.05).In regards to quality of life,the experimental group showed significant improvements compared to the control group on 6 of 10 domains(p<0.05).At 6 months,there were significant improvements in OABSS scores and quality of life in the experimental group compared to the control group(p<0.05).No adverse events were observed.Conclusion:A nurse-led long-term(6 months)pelvic floor muscle training program may alleviate OAB symptoms effectively and improve the quality of life more than a short term(3 months)pelvic floor muscle training program combined with solifenacin succinate tablets.

Research Progress on Compliance of Pelvic Floor Muscle Training in Patients with Urinary Incontinence

This study describes the status quo and related factors of compliance with pelvic floor muscle training at home and abroad, and introduces in detail the current scale of compliance with pelvic floor muscle training at home and abroad, so as to provide a reliable and scientific method for clinical medical staff to objectively evaluate pelvic floor muscle training of patients with urinary incontinence, and also provide a basis for how to improve compliance with pelvic floor muscle training.

Evaluation of therapeutic effects of self-made pelvic floor muscle rehabilitation on elderly female stress urinary incontinence

Objective:Create a pelvic floor muscle rehabilitation program and explore its effects on stress urinary incontinence(SUI)in elderly women.Methods:Pelvic floor muscle rehabilitation was created based on Kaigl experiment and pelvic floor muscle training methods.20 elderly women aged 65-75 years with SUI were randomly recruited for 10 weeks of pelvic floor muscle rehabilitation.Self-control study was used to compare the 72-hour average frequency of urinary incontinence,the average score of urinary incontinence questionnaire-simple form(ICIQ-SF)of international urinary incontinence advisory committee,the severity index of urinary incontinence and the weight of 1 hour urine pad before and after rehibition.Results:After 10 weeks of pelvic floor muscle rehabilitation training,the 72-hour average frequency of urinary incontinence was 1.02±0.65 times,which was not statistically different from that before training(1.25±0.71,P>0.05).The score of ICIQ-SF was 5.95±1.32,which was significantly lower than that before training(7.0±1.38,P<0.05),and the urinary incontinence severity index was 2.75±0.89,which was significantly lower than that before training(3.95±1.32,P<0.01).The weight of 1 hour urine pad was 6.40±2.29 g and was significantly lower than that before training(P<0.01,8.37±2.24).Conclusion:Self-created pelvic floor muscle rehabilitation had the function of decreasing the quantity of urinary incontinence instead of the frequency of incontinence.

Efficacy of biofeedback on stress urinary incontinence in women receiving pelvic floor muscle training: a meta-analysis

Background:To systematically evaluate the effect of pelvic floor muscle training with biofeedback v.s.pelvic floor muscle exercise alone on stress urinary incontinence in women.Methods:PubMed,the Cochrane Library,Web of Science,Ovid,Ebsco,PEDro,WanFang Data,VIP and CNKI databases were electronically searched to collect randomized controlled trials that meet inclusion criteria.After quality assessment,meta-analysis was conducted by RevMan 5.3 software.Results:A total of 8 randomized controlled trials were included.The results of meta-analysis supported the effectiveness of biofeedback on improving pelvic floor muscle strength(MD=4.67,95%CI(1.86,7.49),P=0.001),increasing short(up to 1 hour)pad test(SMD=−1.11,95%CI(−1.84,−0.37),P=0.003),enhancing quality of life(SMD=−0.34,95%CI(−0.67,−0.01),P=0.04)and social activity index(MD=0.1,95%CI(0.06,0.15),P<0.001).Conclusion:Pelvic floor muscle training with biofeedback could improve pelvic floor muscles’strength and help these patients integrate into society,more high quality studies are required to verify above conclusions.

Does Surgery Benefit Postmenopausal Overweight Women with Pelvic Floor Dysfunction?

Introduction: Pelvic floor muscle function of 30 overweight postmenopausal women prior to and after colporrhahpy was monitored in this study. Material and Methods: Patients diagnosed with cystokele or combined cystorectokele was involved. 1 mg oral estriol and local estriol cream were administered for 30 days preoperatively. Pelvic floor muscle function was monitored by surface electromyography 1 month before (1st) 1 day prior to surgery (2nd), and six weeks after the surgery (3rd measurement). Body composition parameters (intra- and extracellular water and body fat) were also measured. Results: The ability to relax significantly improved (p = 0.03) in the preoperative period (between 1st and 2nd occasions). Six weeks after surgery a non-significant (p = 0.054) decrease in average muscle activity was detected when compared with values obtained before the surgery. Muscle-activity declined significantly from the first to the last measurements (p = 0.005). Conclusion: Our results confirm that postmenopausal obese women who undergo anterior or posterior colporrhaphy need a follow-up concerning pelvic floor muscle function and suggest that physiotherapy started the earliest possible may aid in preserving postoperative functionality on the long run.

盆底超声评估妊娠、分娩和盆底肌锻炼对产妇盆底功能的影响

目的探讨盆底超声评估妊娠、分娩和盆底肌锻炼对产妇盆底功能的影响。方法选择2019年1月至2023年1月我院收治的104例产妇,根据干预方式不同分为对照组(n=50)和研究组(n=54)。对照组给予常规妊娠指导和护理,研究组则在妊娠28周后加用盆底肌锻炼。比较两组产后8周的盆底功能和盆底超声检查结果。结果研究组盆底肌力等级显著优于对照组,压力性尿失禁发生率显著低于对照组(P<0.05)。研究组CD、LHD-d、LHLR-d、RAD、BND显著低于对照组(P<0.05)。结论盆底超声可评估妊娠、分娩和盆底肌锻炼产妇的盆底功能;盆底肌锻炼能够显著改善产妇的盆底功能,减少盆腔结构变化,降低压力性尿失禁发生率。

线上产后康复促进项目活动方案的设计及实施

目的探讨线上产后康复促进项目活动方案对产妇产后母乳喂养、形体恢复的效果。方法以便利抽样法抽取符合纳入及排除标准的产妇70例,将产妇随机分为产康组与对照组各35例。对照组实施常规产褥期护理及随访,产康组按照线上产后康复促进项目活动方案实施护理干预。产后6个月比较两组纯母乳喂养率、婴儿体格发育情况、产妇盆底肌肌力及形体恢复情况。结果产后6个月,纯母乳喂养率对照组为42.86%,产康组为88.57%,两组差异有统计学意义(P<0.05)。产康组产妇臀围、腰围显著小于对照组,而盆底肌肌力评分显著高于对照组(均P<0.05)。两组婴儿身长及体质量差异无统计学意义(均P>0.05)。结论对产妇实施线上产后康复促进项目,可提升产妇纯母乳喂养率,促进产后形体恢复、改善盆底肌肌力。

中药督脉熏蒸联合生物反馈训练对产后盆底功能障碍患者盆底肌肌力及尿动力学的影响

目的:观察中药督脉熏蒸联合生物反馈训练治疗产后盆底功能障碍(PPFD)的效果。方法:选取PPFD患者180例,依照随机数字表法分为中药熏蒸组(A组)、生物反馈训练组(B组)、联合治疗组(C组)3组,每组60例。3组均给予常规治疗,即凯格尔运动法及阴道哑铃盆底肌肉锻炼。在常规治疗基础上A组再给予中药督脉熏蒸治疗;B组再给予生物反馈训练;C组再给予中药督脉熏蒸联合生物反馈训练,均治疗8周。治疗前后比较3组患者的盆底肌肌力、尿动力学、盆底神经肌电生理指标、盆底功能障碍影响问卷简版(PFIQ-7)、盆底症状影响量表简版(PFDI-20)、盆腔器官脱垂与尿失禁性功能问卷简版(PISQ-12)评分。结果:治疗后,3组患者的盆底肌肌力正常率、尿道最大闭合压力(MUCP)、功能尿道长度(FUL)、膀胱顺应性(BC)、应力性漏尿点压力(SLPP)、快肌收缩最大值、10s慢肌收缩平均值、PISQ-12评分均高于治疗前(P<0.05),且C组高于A组、B组(P<0.05);3组患者PFIQ-7、PFDI-20均低于治疗前(P<0.05),且C组低于A组、B组(P<0.05)。结论:中药督脉熏蒸联合生物反馈训练可减轻PPFD相关症状,改善PPFD患者盆底功能、性功能。

盆底肌训练在直肠癌患者保肛术后低位前切除综合征中的应用研究进展

盆底肌训练在直肠癌患者低位前切除综合征的预防和治疗中取得了初步效果。文章对盆底肌训练在直肠癌患者保肛术后低位前切除综合征中应用的现状及影响因素和现有研究的不足及展望等进行综述,以期为直肠癌患者盆底肌训练方案的实施提供实践参考。

基于时机理论的盆底肌训练在前列腺癌根治术患者中的应用

目的在机器人辅助腹腔镜下前列腺癌根治术患者中,探讨应用基于时机理论的盆底肌训练干预方法在其中的应用效果。方法选取2021年8月至2022年8月福建医科大学附属第一医院收治的112例行机器人辅助腹腔镜下前列腺癌根治术患者作为研究对象。对照组(n=57)给予常规干预措施,试验组(n=55)在常规干预措施的基础上采用基于时机理论盆底肌训练进行干预,持续干预1年。比较两组患者在术后各个时期的尿控能力、尿失禁康复率、盆底功能康复的效果。结果干预后在术后拔除导尿管当天、术后3个月及6个月时,试验组患者在尿控能力评分、尿失禁康复率、盆底功能康复评分等方面均优于对照组(P<0.05);术后12个月时两组患者的尿控能力评分、尿失禁康复率、盆底功能康复评分比较,差异无统计学意义(P>0.05)。结论基于时机理论盆底肌训练方法具有一定的科学性和可行性,且干预开始时机为术前,可持续至术后1年。在基线水平内可明显改善机器人辅助腹腔镜下前列腺癌根治术患者的术后尿失禁症状,提高尿失禁康复率,可促进患者术后尿控能力的早期康复。

综合干预联合盆底康复治疗对围绝经期女性盆底功能障碍性疾病的影响

目的:探讨综合干预联合盆底康复治疗对围绝经期女性盆底功能障碍性疾病(PFD)的影响。方法:选取2021年10月—2022年12月贵州航天医院收治的160例围绝经期PFD患者作为研究对象,以随机数字表法分为研究组与对照组,各80例。对照组实施盆底肌康复治疗,研究组在对照组基础上进行综合干预。比较两组干预效果。结果:研究组总有效率高于对照组,差异有统计学意义(P=0.043)。干预6、12周后,两组Ⅰ、Ⅱ类肌纤维疲劳度和盆底功能评分逐渐降低,且研究组低于对照组,两组Ⅰ、Ⅱ类肌纤维电压值逐渐升高,且研究组高于对照组,差异有统计学意义(P<0.05)。结论:综合干预联合盆底康复治疗对围绝经期女性PFD的干预效果显著,可改善盆底肌疲劳度、电压值、盆底功能。

机器人辅助前列腺癌根治术后尿失禁经盆底功能训练前置及其延续性治疗效果观察

目的观察盆底功能训练(pelvic floor muscle training,PFMT)前置及其延续性治疗对于经机器人辅助下前列腺癌根治术后尿失禁患者的早期控尿功能康复是否存在积极作用。方法回顾性分析2023年4月至2024年4月四川大学华西医院膀胱康复/管理门诊收治的64例前列腺癌根治术后尿失禁(3个月内)患者的临床资料,根据患者在术前及术后是否进行PFMT分为观察组与对照组,观察组行PFMT前置及延续治疗(n=31),对照组术前及术后均未进行PFMT(n=33)。比较两组年龄、就诊时发生术后尿失禁时间长短、盆底功能评估参数及尿失禁相关参数。结果两组年龄、就诊时平均尿失禁发生时间比较,差异无统计学意义(P>0.05)。观察组慢速肌纤维及快速肌纤维评估参数均高于对照组,差异有统计学意义(P<0.01);观察组每日尿垫数及尿失禁评分均低于对照组,差异有统计学意义(P<0.01)。结论PFMT前置及其延续性治疗,对于经机器人辅助下前列腺癌根治术后尿失禁患者的盆底肌功能早期康复及尿失禁症状改善有着积极作用。

场景互动电子生物反馈训练在女性压力性尿失禁中的临床应用研究

目的探讨场景互动电子生物反馈训练在尿失禁治疗中的作用。方法选取2020年12月—2023年6月之间福建省龙岩市第二医院妇产科收治的患有尿失禁的女性患者120例为研究对象,随机分为2组,各60例。对照组按常规在静卧体位下分步完成电刺激、生物反馈训练;试验组在场景互动下同步进行电刺激、生物反馈和场景生物反馈联合治疗。对比2组患者的盆底肌肌力、子宫脱垂分度、压力性尿失禁、个人生活社会功能评定量表(personal and social performance scale,PSP)、负性情绪[视觉模拟评分法(visual analogue scale,VAS)、文字描述评价量表(verbal descriptors scale VDS)]评价。结果试验组患者的盆底肌肌力、子宫脱垂分度、压力性尿失禁等指标均优于对照组,差异有统计学意义(P<0.05)。PSP评分试验组高于对照组,而试验组VAS评分(32.02±3.26)分、VDS评分(32.23±3.08)分,均低于对照组的(43.23±2.63)分、(44.63±3.09)分,差异有统计学意义(P<0.05)。结论场景互动电子生物反馈训练能有效改善女性尿失禁症状,降低子宫脱垂分度,提高盆底肌肌力与生活社会功能水平,改善不良情绪。

不同干预措施对阴道分娩产妇产后早期盆底肌力恢复的网状Meta分析

目的通过网状Meta分析评价不同干预措施对阴道产后盆底肌力恢复的效果。方法计算机检索Pubmed、Embase、Web of Science、中国知网、万方数据库和中国生物医学文献服务系统,搜集有关阴道分娩产妇产后早期康复的文献,检索时限设定为建库至2021年11月,采用Cochrance手册对纳入的文献进行风险评估,然后采用StataMP 14.2进行网状Meta分析。结果共纳入研究20项,涉及研究对象3537名产妇。网状Meta分析结果显示,对提高阴道分娩产妇盆底肌肌力临床效果排序依次为生物反馈训练+阴道哑铃训练、产后盆底功能锻炼(PFMT)+产后康复教育、PFMT+电刺激+生物反馈训练、PFMT+Bobath球训练、阴道哑铃训练、PFMT+电刺激、电刺激、PFMT+生活干预、PFMT、PFMT+产后瑜伽锻炼+会阴部按摩、产后常规护理。结论生物反馈训练+阴道哑铃训练对提高阴道分娩产妇产后盆底肌肌力效果最佳。

盆底康复在盆腔脏器脱垂患者术后康复中的应用效果

目的:分析盆底康复在盆腔脏器脱垂患者术后康复中的应用效果。方法:选取2020年1月—2024年2月于珠海市妇幼保健院妇科行手术治疗的盆腔脏器脱垂患者394例作为观察样本,随机分为参照组(n=198)、观察组(n=196)。参照组实施常规康复治疗,观察组在参照组基础上实施盆底康复。比较两组康复效果。结果:与参照组相比,观察组康复总有效率更高(P<0.05)。干预后,两组盆底肌力、盆底肌最大收缩力均改善,且相较于参照组,观察组改善幅度更大(P<0.05)。干预后,两组盆底功能障碍问卷、国际尿失禁咨询委员会尿失禁问卷简表评分均下降,且观察组低于参照组(P<0.05)。干预后,两组焦虑、抑郁评分均下降,且观察组低于参照组(P<0.05)。观察组盆底功能及盆底脏器脱垂改善时间短于参照组(P<0.05)。结论:盆底康复在盆腔脏器脱垂患者术后康复中的应用效果显著,可积极改善患者盆底肌力与症状,减轻负性情绪,促进盆底功能恢复。

绝经泌尿生殖综合征的非激素治疗进展

绝经泌尿生殖综合征(GSM)是指围绝经期和绝经后女性雌激素水平显著下降,产生外阴阴道症状、泌尿系统症状以及性生活障碍等的一类慢性进展性疾病,随着年龄增加和绝经时间延长而加重,严重影响中老年女性的生活质量。目前,绝经激素治疗是最有效的疗法,但长期应用激素替代治疗并非适合所有女性。本文将对GSM的非激素治疗的进展进行综述,为临床医生提供治疗策略。

电刺激联合康复护理对女性压力性尿失禁患者的疗效观察

目的分析盆底康复治疗仪电刺激联合康复训练对女性压力性尿失禁患者康复效果,以提供治疗女性压力性尿失禁更好的办法。方法选取本院2021年01月-2021年12月间,门诊确诊的压力性尿失禁女性患100例,并应用盆底康复治疗仪电刺激进行治疗的患者作为观察对象,采用等量电脑随机分组法,分为参照组(行常规护理)和研究组(行康复护理),每组纳入50例,比较两组应用效果。结果盆底康复治疗仪电刺激治疗及护理前,两组盆底肌力评分较低,尿失禁评分较高。盆底康复治疗仪电刺激治疗及护理后,两组盆底肌力评分升高,且研究组高于参照组,尿失禁评分降低,且研究组低于参照组(P<0.05),研究组护理满意度、依从性高于参照组(P<0.05)。结论盆底康复治疗仪电刺激治疗联合康复护理应用在压力性尿失禁女性患者中,可提高治疗效果,促进盆底肌力恢复,改善尿失禁,取得积极配合,获得满意评价,具有推广价值。

低频神经肌肉刺激治疗产后盆底肌力减退的效果分析

目的:分析低频神经肌肉刺激治疗产后盆底肌力减退的效果。方法:选取2021年1月—2022年1月南方医科大学南方医院收治的产后盆底肌力减退患者300例作为研究对象,采用随机数字表法分为对照组和观察组,各150例。对照组实施常规产后盆底康复训练,观察组在对照组基础上实施低频神经肌肉刺激治疗。比较两组临床疗效、盆底肌力、漏尿情况、盆底功能。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.004)。观察组盆底肌力优于对照组,差异有统计学意义(P<0.001)。干预后,两组漏尿次数、漏尿量评分低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组盆底功能评分低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:低频神经肌肉刺激治疗产后盆底肌力减退的效果显著,可改善漏尿情况,提高盆底肌力,改善盆底功能。

电针八髎穴联合盆底肌训练预防无痛分娩初产妇产后尿潴留效果的临床研究

目的:观察电针八髎穴联合盆底肌训练预防无痛分娩初产妇产后尿潴留的临床效果。方法:将2020年8月~2023年10月在我院妇产科进行无痛分娩的120例初产妇采用随机法分为两组,单组60例。两组产后均鼓励产妇及时水分摄入,热敷下腹部和骶尾部,同时对照组产后30min给予盆底肌训练,观察组在盆底肌训练基础上联合电针八髎穴进行干预。记录两组产后首次排尿时间、初次泌乳时间、首次排尿量,检测两组尿动力学参数和泌乳素水平,统计两组产后尿潴留、尿失禁及尿路感染发生率,评估两组SF-36评分差异。结果:观察组首次排尿时间短于对照组,首次排尿量高于对照组,最大尿流率、最大膀胱容量高于对照组,膀胱残余尿量低于对照组,产后尿潴留发生率低于对照组,有差异(P<0.05)。观察组除躯体角色、社会功能、心理健康评分与对照组比较,无差异(P>0.05)外,其他评分高于对照组(P<0.05)。结论:电针八髎穴联合盆底肌训练可预防无痛分娩初产妇产后尿潴留的发生,并提高生活质量。