Purpose: The study aimed to show differences in temporal recovery of pelvic floor function within 6 months postpartum between women having their first delivery at an advanced age and those having their first delivery ...Purpose: The study aimed to show differences in temporal recovery of pelvic floor function within 6 months postpartum between women having their first delivery at an advanced age and those having their first delivery at a younger age. Methods: Seventeen women (age: 35.5 ± 3.5, BMI: 21.1 ± 3.2) were studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire-Short Form. Pelvic floor function was assessed by the anteroposterior diameter of the levator hiatus using transperineal ultrasound. Women who delivered for the first time at 35 years and/or older were defined as being of advanced maternal age. Results: Nine of 17 women (52.9%) were of advanced maternal age and 5 experienced postpartum stress urinary incontinence. Four of these 5 women (80.0%) were of advanced maternal age. The anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 3 and 6 months postpartum (p < 0.01). Among the continent women, the anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 6 months postpartum (p = 0.004). However, among the advanced maternal age women, all parameters of the anteroposterior diameter of the levator hiatus were not significantly different between the women with and without stress urinary continence. Conclusion: Recovery of pelvic floor function following delivery may be delayed in women of advanced maternal age at first delivery because of the damage to the pelvic floor during pregnancy and vaginal delivery, resulting in increase in the incidence of stress urinary incontinence.展开更多
BACKGROUND Pelvic floor dysfunction(PFD)is related to muscle fiber tearing during childbirth,negatively impacting postpartum quality of life of parturient.Appropriate and effective intervention is necessary to promote...BACKGROUND Pelvic floor dysfunction(PFD)is related to muscle fiber tearing during childbirth,negatively impacting postpartum quality of life of parturient.Appropriate and effective intervention is necessary to promote PFD recovery.AIM To analyze the use of hydrogen peroxide and silver ion disinfection for vaginal electrodes in conjunction with comprehensive rehabilitation therapy for postpartum women with PFD.METHODS A total of 59 women with PFD who were admitted to the hospital from May 2019 to July 2022 were divided into two groups:Control group(n=27)received comprehensive rehabilitation therapy and observation group(n=32)received intervention with pelvic floor biostimulation feedback instrument in addition to comprehensive rehabilitation therapy.The vaginal electrodes were disinfected with hydrogen peroxide and silver ion before treatment.Intervention for both groups was started 6 weeks postpartum,and rehabilitation lasted for 3 months.Pelvic floor muscle voltage,pelvic floor muscle strength,vaginal muscle voltage,vaginal muscle tone,pelvic floor function,quality of life,and incidence of postpartum PFD were compared between the two groups.RESULTS Before comprehensive rehabilitation treatment,basic data and pelvic floor function were not significantly different between the two groups.After treatment,the observation group showed significant improvements in the maximum voltage and average voltage of pelvic floor muscles,contraction time of type I and type II fibers,pelvic floor muscle strength,vaginal muscle tone,vaginal muscle voltage,and quality of life(GQOLI-74 reports),compared with the control group.The observation group had lower scores on the pelvic floor distress inventory(PFDI-20)and a lower incidence of postpartum PFD,indicating the effectiveness of the pelvic floor biostimulation feedback instrument in promoting the recovery of maternal pelvic floor function.CONCLUSION The combination of the pelvic floor biostimulation feedback instrument and comprehensive rehabilitation nursing can improve pelvic floor muscle strength,promote the recovery of vaginal muscle tone,and improve pelvic floor function and quality of life.The use of hydrogen peroxide and silver ion disinfectant demonstrated favorable antibacterial efficacy and is worthy of clinical application.展开更多
The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affec...The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affect different organ systems. In the urogenital tract, these changes usually cause vulvar and vaginal atrophy, affecting a vaginal health of women and decreasing their quality of life. Also, there is a reduction in vaginal moisture and loss of tissue elasticity. Besides, other organ systems are involved and they can also negatively impact normal vaginal physiology. These evolutional changes frequently lead to bothersome symptoms that can negatively impact a woman’s vaginal health and the quality of life. The role of pelvic floor physiotherapy is to improve the tone and strength of the muscle fibres in order to achieve the increase of motor units, improve muscle elasticity and to increase the muscle mass which will help to alleviate menopause symptoms.展开更多
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...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。展开更多
目的:探讨新型温控射频对产后阴道松弛症的临床疗效与安全性。方法:选取2022年6月-2023年6月于清华大学附属北京清华长庚医院收治的43例产后阴道松弛症患者为研究对象,随机分为2组,试验组(21例)接受新型温控射频治疗,对照组(22例)接受...目的:探讨新型温控射频对产后阴道松弛症的临床疗效与安全性。方法:选取2022年6月-2023年6月于清华大学附属北京清华长庚医院收治的43例产后阴道松弛症患者为研究对象,随机分为2组,试验组(21例)接受新型温控射频治疗,对照组(22例)接受假开机治疗(无温度及能量)。通过比较治疗前后女性性功能指数量表(female sexual function index,FSFI)、女性性困扰诊断量表修订版(female sexual distress scale-revised,FSDS-R)、阴道松弛问卷(vaginal laxity questionnaire,VLQ)以及性生活满意度问卷(sexual satisfaction questionnaire,SSQ)的主观评分,结合对小阴唇基底边长、外阴着色和弹性等指标的客观评估,综合评价射频治疗的临床疗效与安全性。结果:试验组患者首次治疗后第18周较基线的FSFI总分改变值(△T)的均值为(8.72±3.94)分,对照组(△C)为(-0.03±1.28)分,2组平均FSFI总分改变值的差值(△T-△C)为8.75分,95%CI为6.889~10.613分,组间差值的95%CI下限大于0,试验组FSFI评分优于对照组(t=4.810,P<0.001)。两因素重复测量方差分析结果显示,FSFI评分的时间主效应(F时间=24.156,P时间<0.001)、组别主效应(F组别=12.754,P组别=0.001)、时间×组别的交互作用(F时间×组别=25.689,P时间×组别<0.001)均有统计学意义。以组别为自变量的干预效应表明,治疗6、10、18周后,试验组FSFI评分高于对照组,差异有统计学意义(均P<0.05)。以时间为自变量的时间效应表明,治疗后各时间点的FSFI评分均高于治疗前,且治疗6、10、18周后的FSFI评分均高于治疗3周后,差异有统计学意义(均P<0.05);而治疗6、10、18周后的FSFI评分比较,差异无统计学意义(均P>0.05)。治疗10、18周后,试验组FSDS-R评分、小阴唇基底边长均低于对照组,SSQ评分高于对照组,差异有统计学意义(均P<0.05)。治疗3、6、10、18周后,试验组VLQ评分、指测阴道松弛改善程度及外阴状态均优于对照组,差异均有统计学意义(均P<0.05)。所有入组患者均未出现与试验器械相关的不良事件。结论:新型温控射频技术有助于改善患者阴道松弛度,提高性生活满意度,治疗安全性高,值得临床推广应用。展开更多
目的调查宫颈癌患者术后发生盆底功能障碍性疾病(pelvic fl oor dysfunction,PFD)现状,分析影响因素并提出预防措施。方法选取2023年1—7月在长沙市某三级甲等医院住院的宫颈癌根治术后患者178例为调查对象,使用自行设计的问卷对患者进...目的调查宫颈癌患者术后发生盆底功能障碍性疾病(pelvic fl oor dysfunction,PFD)现状,分析影响因素并提出预防措施。方法选取2023年1—7月在长沙市某三级甲等医院住院的宫颈癌根治术后患者178例为调查对象,使用自行设计的问卷对患者进行横调查,并使用Logistic回归分析宫颈癌根治术后患者盆底功能障碍性疾病的影响因素。结果178例宫颈癌根治术后患者中,105例患者(58.99%)存在盆底功能障碍性疾病,单因素分析结果显示,年龄、妊娠次数、分娩方式、肿瘤直径、绝经、便秘、留置导尿管时间、阴道切除长度均是影响宫颈癌根治术后患者发生盆底功能障碍性疾病的因素(P<0.05),多因素Logistic回归分析结果显示,绝经、便秘、妊娠次数、分娩方式、留置导尿管时间、阴道切除长度为宫颈癌根治术后患者发生盆底功能障碍性疾病的影响因素(P<0.05)。结论宫颈癌根治术后患者女性盆底功能障碍(female pelvic fl oor dysfunction,FPFD)发生率高,绝经、便秘、妊娠次数≥3,阴道分娩、留置导尿管时间≥7 d、阴道切除长度≥3 cm是宫颈癌根治术后患者发生FPFD的危险因素,提示护理人员应给予此类患者更多关注,制定盆底康复训练计划,早期评估FPFD的发生,尽早采取有针对性的措施进行干预。展开更多
文摘Purpose: The study aimed to show differences in temporal recovery of pelvic floor function within 6 months postpartum between women having their first delivery at an advanced age and those having their first delivery at a younger age. Methods: Seventeen women (age: 35.5 ± 3.5, BMI: 21.1 ± 3.2) were studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire-Short Form. Pelvic floor function was assessed by the anteroposterior diameter of the levator hiatus using transperineal ultrasound. Women who delivered for the first time at 35 years and/or older were defined as being of advanced maternal age. Results: Nine of 17 women (52.9%) were of advanced maternal age and 5 experienced postpartum stress urinary incontinence. Four of these 5 women (80.0%) were of advanced maternal age. The anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 3 and 6 months postpartum (p < 0.01). Among the continent women, the anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 6 months postpartum (p = 0.004). However, among the advanced maternal age women, all parameters of the anteroposterior diameter of the levator hiatus were not significantly different between the women with and without stress urinary continence. Conclusion: Recovery of pelvic floor function following delivery may be delayed in women of advanced maternal age at first delivery because of the damage to the pelvic floor during pregnancy and vaginal delivery, resulting in increase in the incidence of stress urinary incontinence.
文摘BACKGROUND Pelvic floor dysfunction(PFD)is related to muscle fiber tearing during childbirth,negatively impacting postpartum quality of life of parturient.Appropriate and effective intervention is necessary to promote PFD recovery.AIM To analyze the use of hydrogen peroxide and silver ion disinfection for vaginal electrodes in conjunction with comprehensive rehabilitation therapy for postpartum women with PFD.METHODS A total of 59 women with PFD who were admitted to the hospital from May 2019 to July 2022 were divided into two groups:Control group(n=27)received comprehensive rehabilitation therapy and observation group(n=32)received intervention with pelvic floor biostimulation feedback instrument in addition to comprehensive rehabilitation therapy.The vaginal electrodes were disinfected with hydrogen peroxide and silver ion before treatment.Intervention for both groups was started 6 weeks postpartum,and rehabilitation lasted for 3 months.Pelvic floor muscle voltage,pelvic floor muscle strength,vaginal muscle voltage,vaginal muscle tone,pelvic floor function,quality of life,and incidence of postpartum PFD were compared between the two groups.RESULTS Before comprehensive rehabilitation treatment,basic data and pelvic floor function were not significantly different between the two groups.After treatment,the observation group showed significant improvements in the maximum voltage and average voltage of pelvic floor muscles,contraction time of type I and type II fibers,pelvic floor muscle strength,vaginal muscle tone,vaginal muscle voltage,and quality of life(GQOLI-74 reports),compared with the control group.The observation group had lower scores on the pelvic floor distress inventory(PFDI-20)and a lower incidence of postpartum PFD,indicating the effectiveness of the pelvic floor biostimulation feedback instrument in promoting the recovery of maternal pelvic floor function.CONCLUSION The combination of the pelvic floor biostimulation feedback instrument and comprehensive rehabilitation nursing can improve pelvic floor muscle strength,promote the recovery of vaginal muscle tone,and improve pelvic floor function and quality of life.The use of hydrogen peroxide and silver ion disinfectant demonstrated favorable antibacterial efficacy and is worthy of clinical application.
文摘The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affect different organ systems. In the urogenital tract, these changes usually cause vulvar and vaginal atrophy, affecting a vaginal health of women and decreasing their quality of life. Also, there is a reduction in vaginal moisture and loss of tissue elasticity. Besides, other organ systems are involved and they can also negatively impact normal vaginal physiology. These evolutional changes frequently lead to bothersome symptoms that can negatively impact a woman’s vaginal health and the quality of life. The role of pelvic floor physiotherapy is to improve the tone and strength of the muscle fibres in order to achieve the increase of motor units, improve muscle elasticity and to increase the muscle mass which will help to alleviate menopause symptoms.
文摘目的通过网状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。
文摘目的:探讨新型温控射频对产后阴道松弛症的临床疗效与安全性。方法:选取2022年6月-2023年6月于清华大学附属北京清华长庚医院收治的43例产后阴道松弛症患者为研究对象,随机分为2组,试验组(21例)接受新型温控射频治疗,对照组(22例)接受假开机治疗(无温度及能量)。通过比较治疗前后女性性功能指数量表(female sexual function index,FSFI)、女性性困扰诊断量表修订版(female sexual distress scale-revised,FSDS-R)、阴道松弛问卷(vaginal laxity questionnaire,VLQ)以及性生活满意度问卷(sexual satisfaction questionnaire,SSQ)的主观评分,结合对小阴唇基底边长、外阴着色和弹性等指标的客观评估,综合评价射频治疗的临床疗效与安全性。结果:试验组患者首次治疗后第18周较基线的FSFI总分改变值(△T)的均值为(8.72±3.94)分,对照组(△C)为(-0.03±1.28)分,2组平均FSFI总分改变值的差值(△T-△C)为8.75分,95%CI为6.889~10.613分,组间差值的95%CI下限大于0,试验组FSFI评分优于对照组(t=4.810,P<0.001)。两因素重复测量方差分析结果显示,FSFI评分的时间主效应(F时间=24.156,P时间<0.001)、组别主效应(F组别=12.754,P组别=0.001)、时间×组别的交互作用(F时间×组别=25.689,P时间×组别<0.001)均有统计学意义。以组别为自变量的干预效应表明,治疗6、10、18周后,试验组FSFI评分高于对照组,差异有统计学意义(均P<0.05)。以时间为自变量的时间效应表明,治疗后各时间点的FSFI评分均高于治疗前,且治疗6、10、18周后的FSFI评分均高于治疗3周后,差异有统计学意义(均P<0.05);而治疗6、10、18周后的FSFI评分比较,差异无统计学意义(均P>0.05)。治疗10、18周后,试验组FSDS-R评分、小阴唇基底边长均低于对照组,SSQ评分高于对照组,差异有统计学意义(均P<0.05)。治疗3、6、10、18周后,试验组VLQ评分、指测阴道松弛改善程度及外阴状态均优于对照组,差异均有统计学意义(均P<0.05)。所有入组患者均未出现与试验器械相关的不良事件。结论:新型温控射频技术有助于改善患者阴道松弛度,提高性生活满意度,治疗安全性高,值得临床推广应用。
文摘目的调查宫颈癌患者术后发生盆底功能障碍性疾病(pelvic fl oor dysfunction,PFD)现状,分析影响因素并提出预防措施。方法选取2023年1—7月在长沙市某三级甲等医院住院的宫颈癌根治术后患者178例为调查对象,使用自行设计的问卷对患者进行横调查,并使用Logistic回归分析宫颈癌根治术后患者盆底功能障碍性疾病的影响因素。结果178例宫颈癌根治术后患者中,105例患者(58.99%)存在盆底功能障碍性疾病,单因素分析结果显示,年龄、妊娠次数、分娩方式、肿瘤直径、绝经、便秘、留置导尿管时间、阴道切除长度均是影响宫颈癌根治术后患者发生盆底功能障碍性疾病的因素(P<0.05),多因素Logistic回归分析结果显示,绝经、便秘、妊娠次数、分娩方式、留置导尿管时间、阴道切除长度为宫颈癌根治术后患者发生盆底功能障碍性疾病的影响因素(P<0.05)。结论宫颈癌根治术后患者女性盆底功能障碍(female pelvic fl oor dysfunction,FPFD)发生率高,绝经、便秘、妊娠次数≥3,阴道分娩、留置导尿管时间≥7 d、阴道切除长度≥3 cm是宫颈癌根治术后患者发生FPFD的危险因素,提示护理人员应给予此类患者更多关注,制定盆底康复训练计划,早期评估FPFD的发生,尽早采取有针对性的措施进行干预。
