Curative effect of hydrogen peroxide combined with silver ion disinfection on pelvic floor dysfunction

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.

Clinical efficacy of integral theory–guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females

BACKGROUND Internal rectal prolapse(IRP)is one of the most common causes of obstructive constipation.The incidence of IRP in women is approximately three times that in men.IRP is mainly treated by surgery,which can be divided into two categories:Abdominal procedures and perineal procedures.This study offers a better procedure for the treatment of IRP.AIM To compare the clinical efficacy of laparoscopic integral pelvic floor/ligament repair(IPFLR)combined with a procedure for prolapse and hemorrhoids(PPH)and the laparoscopic IPFLR alone in the treatment of IRP in women.METHODS This study collected the clinical data of 130 female patients with IRP who underwent surgery from January 2012 to October 2014.The patients were divided into groups A and B.Group A had 63 patients who underwent laparoscopic IPFLR alone,and group B had 67 patients who underwent the laparoscopic IPFLR combined with PPH.The degree of internal rectal prolapse(DIRP),Wexner constipation scale(WCS)score,Wexner incontinence scale(WIS)score,and Gastrointestinal Quality of Life Index(GIQLI)score were compared between groups and within groups before surgery and 6 mo and 2 years after surgery.RESULTS All laparoscopic surgeries were successful.The general information,number of bowel movements before surgery,DIRP,GIQLI score,WIS score,and WCS score before surgery were not significantly different between the two groups(all P>0.05).The WCS score,WIS score,GIQLI score,and DIRP in each group 6 mo,and 2 years after surgery were significantly better than before surgery(P<0.001).In group A,the DIRP and WCS score gradually improved from 6 mo to 2 years after surgery(P<0.001),and the GIQLI score progressively improved from 6 mo to 2 years after surgery(P<0.05).In group B,the DIRP,WCS score and WIS score significantly improved from 6 mo to 2 years after surgery(P<0.05),and the GIQLI score 2 years after surgery was significantly higher than that 6 mo after surgery(P<0.05).The WCS score,WIS score,GIQLI score,and DIRP of group B were significantly better than those of group A 6 mo and 2 years after surgery(all P<0.001,Bonferroni)except DIRP at 2 years after surgery.There was a significant difference in the recurrence rate of IRP between the two groups 6 mo after surgery(P=0.011).There was no significant difference in postoperative grade I-III complications between the two groups(P=0.822).CONCLUSION Integral theory–guided laparoscopic IPFLR combined with PPH has a higher cure rate and a better clinical efficacy than laparoscopic IPFLR alone.

Mine disaster survivor’s pelvic floor hernia treated with laparoscopic surgery and a perineal approach:A case report

BACKGROUND A pelvic floor hernia is defined as a pelvic floor defect through which the intraabdominal viscera may protrude.It is an infrequent complication following abdominoperineal surgeries.This type of hernia requires surgical repair by conventional or reconstructive techniques.The main treatments could be transabdominal,transperineal or a combination.CASE SUMMARY In this article,we present the case of a recurrent perineal incisional hernia,postresection of the left side of the pelvis,testis and lower limbs resulting from a mine disaster 18 years ago.Combined laparoscopic surgery with a perineal approach was performed.The pelvic floor defect was repaired by a biological mesh and one pedicle skin flap.No signs of recurrence were indicated during the 2 years of follow-up.CONCLUSION The combination of laparoscopic surgery with a perineal approach was effective.The use of the biological mesh and pedicle skin flap to restructure the pelvic floor was effective.

Expression and significance of lysyl oxidase-like 1 and fibulin-5 in the cardinal ligament tissue of patients with pelvic floor dysfunction

Pelvic organ prolapse （POP） is a disabling disorder in women characterized by a loss of pelvic floor support, leading to the herniation of the uterus into or through the vagina. POP is a complex problem that likely involves multiple mechanisms with limited therapies available, and is associated with defects in connective tissue including elastic fibers. This study was designed to investigate the expression of fibulin-5 and lysyl oxidase-like 1 （LOXL1） in the cardinal ligament in samples taken from the POP group compared to the non-POP group. Specimens were obtained during abdominal hysterectomy from the cardinal ligament of 53 women with POP and 25 age- and par- ity- matched women with non-POP among post-menopausal women with benign gynecologic pathology. Protein expression was evaluated using the immunohistochemical staining method. For statistical analyses, chi-square test and Spearman＇s correlation were used with the statistical package SPSS13.0 system. Our results showed that both fibulin-5 and LOXL1 expressions were decreased in the cardinal ligament in the POP group compared to the non- POP group （P 〈 0.05）. The expression of fibulin-5 and LOXL1 were correlated closely with the stage of POP, ac- companied by stress urinary incontinence and frequency of vaginal delivery （P 〈 0.05）, but had no relationship with post-menopausal state （P 〉 0.05）. The expression of fibulin-5 was positively associated with LOXL1 in POP （P 〈 0.05）. We conclude that changes in fibulin-5 and LOXL1 expression may play a role in the development of POP.

Technical Innovation of Electrostimulation Biofeedback Combined with Vaginal Dumbbell in the Treatment of Postpartum Pelvic Floor Dysfunction

Objective: To investigate the application value of electrostimulation biofeedback therapy in combination with vaginal dumbbell therapy to postpartum pelvic floor dysfunction. Methods: Retrospective analysis of 200 cases of postpartum pelvic floor dysfunction patients discharged from the hospital from January 2016 to March 2019 as study subjects who were excluded other underlying diseases and were randomly divided into two groups of 100 cases per group, using electrostimulation biofeedback therapy combined vaginal dumbbell therapy as a treatment group. The treatment of electrostimulation biofeedback therapy in combination with kegel was treated as a control group. Then the curative effects of the two groups were compared and statistically analyzed. Results: There was no significant difference in EMG value of postpartum pelvic floor treatment, type I muscle strength, type II muscle strength, muscle type I fatigue, type II fatigue and POP-Q detection results between the two groups before treatment, p > 0.05. There were significant differences in type I muscle strength, type II muscle strength and muscle type I fatigue between the pelvic floor muscles and the muscles at the end of the treatment day, the sixth month and one year after treatment, p ?There was no statistically significant difference at?the end of muscle type II fatigue?treatment day, p > 0.05;while after the treatment of six months and one year, the difference was statistically significant, p 0.05. In addition, the treatment group and the control group were compared before and after treatment, the difference of myoelectric potential value, pelvic floor muscle type I muscle strength, type II muscle strength, muscle type I fatigue degree, type II fatigue degree and POP-Q test result were significant, and the changes in the indicators before and after treatment in the treatment group were significantly higher than the control group. Comparison of urinary incontinence between the two groups before and after treatment, the difference between pre-treatment and the end of treatment day was not statistically significant, p > 0.05;there was significant difference between half a year and one year after treatment (p 0.05, respectively). Comparing?the satisfaction with sexual life after the time of treatment day, half a year and one year after the end of treatment, the difference was statistically significant (p ?Conclusion: Electrical stimulation biofeedback therapy combined with vaginal dumbbell therapy has a good effect in the treatment of postpartum pelvic floor dysfunction, and it is worthy of popularization and application.

Quantitatively evaluation on pelvic floor dysfunction by virtual touch tissue imaging quantification shear wave elastography

Objective:To investigate the value of(VTIQ)shear wave elastography in the diagnosis of pelvic floor dysfunction.Methods:20 patients with pelvic floor dysfunction and 40 healthy volunteers were enrolled in and devided into the pelvic floor dysfunction(PFD)group and the control group.20 cases in the normal non-fertile(NNF)group and the normal fertile(NF)group respectively were including in the control group.The Young's modulus of puborectalis(PR)in three groups was measured by virtual touch tissue imaging quantification(VTIQ)at different states.The Young's modulus of PR and their differences in the three groups and between groups were compared and calculated.Receiver-operating characteristic curve(ROC)analyses were performed to assess the diagnostic value of VTIQ,and the area under the curve(AUC)was compared.Results:Young's modulus of PR at resting-state,maximun rectal state and Vasalva state in NNF group and NF group were statistical significance(all P<0.05).Young's modulus of maximun rectal state was higher than that of resting-state and Vasalva state in PFD group(P<0.05).There was no significant difference in Young's modulus between the resting-state and Vasalva state in the PFD group(P>0.05).Difference of PR Young's modulus between resting status and maximun rectal state and that between resting status and Vasalva state were of statistical significance among the three groups(all P<0.05).ROC curves analyses indicated that the AUC,cut-off value,sensitivity,specificity and Youden index of the difference between the Young's modulus of resting status and maximun rectal state measured by VTIQ in control group and PFD group were 0.788,35.45kPa,91.67%,57.14%,0.488,espectively.The AUC,cut-off value,sensitivity,specificity and Youden index of the difference between the Young's modulus of resting status and Vasalva state measured by VTIQ in control group and PFD group were 0.799,14.00kPa,63.89%,85.71%,0.496,respectively.There was no significant difference in AUC between the two groups(Z=0.130,P>0.05).Conclusion:VTIQ technology is an effective method to quantitatively assess the biomechanical properties of PR.The effect of labor on the puborectalis muscle was not significant.The increase of Young's modulus of passive stretching in vasalva state was not significant in patients with pelvic floor dysfunction.The difference between resting status and maximun rectal state and difference between resting status and Vasalva state is more advantageous to the diagnosis of pelvic floor dysfunction disorder.

Effect of pelvic floor rehabilitation technique in preventing the postpartum pelvic floor dysfunction

Objective:To explore the effect of pelvic floor rehabilitation technique in preventing the postpartum pelvic floor dysfunction and on the sexual life quality.Methods:A total of 286 puerpera with pelvic floor dysfunction who were admitted in our hospital from May, 2014 to May, 201542 d after delivery were included in the study, and randomized into the treatment group and the control group with 143 cases in each group. After guidance, the puerpera in the control group were given pelvic floor muscle training by themselves at home. On this basis, the puerpera in the treatment group were treated by the pelvic floor rehabilitation apparatus. The puerpera in the two groups were treated for 4 weeks. The pelvic floor function before treatment, 6 months and 1 year after delivery was detected. The color Doppler ultrasound apparatus was used to detect BSD, PUVA, UVJ-M, and BND 3 months after delivery.Results:BND, PUVA-R, PUVA-S, and UVJ-M 3 months after delivery in the treatment groups were significantly lower than those in the control group, while BSD-S was significantly higher than that in the control group. The improvement of type I and Ⅱ muscle fiber fatigue (%), POP-Q degree, AP indication point (cm), and vaginal dynamic pressure (cmH2O) was significantly superior to that in the control group. The comparison of pelvic floor muscle strength classification before treatment between the two groups was not statistically significant. After treatment, the pelvic floor muscle in the two groups was significantly strengthened, and the proportion of V grade patients was significantly increased when compared with before treatment.Conclusions: The postpartum early pelvic floor rehabilitation technique can effectively enhance the pelvic floor function, and prevent the postpartum pelvic floor dysfunction, with an accurate efficacy;therefore, it deserves to be widely recommended in the clinic.

Tannic acid-loaded hydrogel coating endues polypropylene mesh with hemostatic and antiinflammatory capacity for facilitating pelvic floor repair

The application of polypropylene mesh(PPM)in pelvic organ prolapse(POP)treatment was severely limited by the complications associated with PPM,such as mesh exposure,chronic inflammatory reactions and postoperative hematoma.This study applied a method of fabricating a hydrogel-mesh complex(PPM+TA@GelMA)to cross-link tannic acid(TA)directly with Methacrylate Gelatin(GelMA)hydrogel and thus to form a coating for PPM.This one-step coating modification improved the hydrophilicity and cyto-compatibility of PPM.The hemostatic effect of PPMtTA@GelMA was confirmed through tail amputation test.Through the defect tissue repair experiments in vivo,it was proved that PPMtTA@GelMA had effects of anti-inflammation and promoting tissue repair and regulated the M2 subtype macrophages polarization for tissue repair.The TAloaded hydrogel coating endued PPM with multiple functions.It is believed that the novel hydrogel-mesh complex and its fabrication method will have great significance in basic research and clinical application.

Uterus-reserved or hysterectomized total pelvic floor reconstruction for female pelvic dysfunction:a clinical analysis of 74 cases

Objective To evaluate the effectiveness and safety of the entire pelvic floor reconstruction(Prolift) with uterus reserved in the treatment of pelvic floor dysfunction diseases.Methods From March 2008 to January 2009,74 female cases from our hospital who had different defects in pelvic organ prolapse were treated with the entire reconstructive pelvic surgery,in which 38 had uterus retained(observation group) and 36 cases had hysterectomy(control group).The two groups were compared.The patients with combined stress urinary incontinence had transobturator tension-free vaginal tape(TVT-O technique) at the same time.The results of operations were objectively evaluatedaccording to Pelvic Organ Prolapse Quantification sub-degree method(POP-Q) developed by the International Continence Society.Results For observation group,the average operative time was 50 min,and the average amount of bleeding was 100 mL.For control group,the average operative time was 110 min,and the average amount of bleeding was 200 mL.During the postoperative follow-up(8 ~18 months),in the observation group the structures of patients' pelvic floor were normal;stress urinary incontinence was all cured;related symptoms disappeared or were markedly improved;and no postoperative infection appeared.In control group,two cases had postoperative infection;the patients ' pelvic structures were normal during the postoperative follow-up;the related symptoms disappeared or were significantly improved.After 3 months,POP-Q score was significantly elevated in the two groups.Conclusion Full reconstructive pelvic surgery with uterus retained can complete the whole pelvic floor structure and function of all or part of the reconstruction with fast recovery and clear short-term effect.However,the long-term efficacy remains to be revealed.

A novel antibacterial biomaterial mesh coated by chitosan and tigecycline for pelvic floor repair and its biological performance

The biomaterials composed of mammalian extracellular matrix(ECM)have a great potential in pelvic floor tissue repair and functional reconstruction.However,bacterial infection does cause great damage to the repair function of biomaterials which is the major problem in clinical utilization.Therefore,the development of biological materials with antimicrobial effect is of great clinical significance for pelvic floor repair.Chitosan/tigecycline(CS/TGC)antibacterial biofilm was prepared by coating CS/TGC nanoparticles on mammalian-derived ECM.Infrared spectroscopy,scanning electron microscopy,bacteriostasis circle assay and static dialysis methods were used to characterize the membrane.MTS assay kit and DAPI fluorescence staining were used to evaluate cytotoxicity and cell adhesion.The biocompatibility was assessed by subabdominal implantation model in goats.Subcutaneous antimicrobial test in rabbit back was used to evaluate the antimicrobial and repairing effects on the infected wounds in vivo.Infrared spectroscopy showed that the composite coating had been successfully modified.The antibacterial membrane retained the main structure of ECM multilayer fibers.In vitro release of biomaterials showed sustained release and stability.In vivo studies showed that the antibacterial biological membrane had low cytotoxicity,fast degradation,good compatibility,anti-infection and excellent repair ability.

Chinese expert consensus on primary prevention for pelvic floor dysfunction during pregnancy

Objective Pregnancy has been identified as a risk factor for pelvic floor dysfunction(PFD).The aim of this study was to establish primary prevention measures for PFD during pregnancy and reduce the overall incidence of PFD.Methods We assembled a panel of 36 experts,including gynecologists,obstetricians,and physiotherapists.Through surveys and expert meetings,the panel reviewed and assessed the safety and effectiveness of various clinical interventions.Based on expert comments from Round 1,a revised list of 8 clinical interventions was developed and submitted for a second round of expert review.Results A consensus was reached on the importance of implementing prevention measures to protect pelvic floor function during pregnancy.Experts particularly emphasized the significance of health education,weight management,pelvic floor muscle training,respiratory training,overall exercise,physical activity,and perineal massage.Conclusion The expert consensus provides comprehensive clinical measures to safeguard pelvic floor function during pregnancy.This paper represents the initial step toward developing scientific recommendations for pregnant women regarding the primary prevention of PFD.Future research should focus on the implementation of these recommendations in clinical practice.

Implementing of Electronic Medical Record in Pelvic Floor Ward: A Pilot Study

The electronic medical record is an essential technology tool to improve the quality of care. In present study we reported on the design and feasibility of electronic medical records in Female Pelvic Floor Dysfunction Ward. Our main goal was documentation with the least possible missed data, evidence-based decision making, documented active patient follow up and increasing patient’s satisfaction. The Electronic Registry System of Female Pelvic Floor Dysfunction (Vali e Asr Hospital, Tehran, Iran) was designed in mid 2014 and tested till March 2015. The software description was designed based on previous paper questionnaire used in this ward. The electronic questionnaires were filled in upon hospitalization and thereafter including follow ups. The questionnaire included 10 demographic and 15 main questions. A digital analog scale (1 - 10) in each part quantified the effects of problem on patient’s quality of life and also the effects of interventions as well. Entered information in each step was available for those with defined access. Reporting design was dependent on the needed data. Our supervised data entry was a guarantee to the quality of information with the least errors. Access to all para clinical data made rapid and evidence-based decision making. Patient satisfaction was achieved because of unified approach. The most interesting part was access to evidence-based results and data to be used in research projects. This study showed that EMRs in Female Pelvic Floor Dysfunction Wards could provide valuable information, improve the quality of care and increase patient’s satisfaction.

经会阴盆底超声参数对盆底功能障碍性疾病的监测效果及对盆底康复治疗的指导价值

目的探究经会阴盆底超声参数对盆底功能障碍性疾病(PFD)的监测效果及对盆底康复治疗的指导价值。方法选取2021年1月至2022年6月江苏省连云港市妇幼保健院119例产后42 d发现的PFD患者作为研究对象,根据分娩情况分为初产妇组(n=59)和经产妇组(n=60)。比较两组及不同分娩方式患者盆底超声参数,所有患者均行盆底康复治疗,治疗1个月后统计疗效,分析各参数预测疗效的价值。结果经产妇组尿道旋转角、膀胱后角、膀胱移动度、肛提肌裂孔面积(最大Valsalva动作)均高于初产妇组(P<0.05);两组中自然分娩孕妇尿道旋转角、膀胱后角、膀胱移动度、肛提肌裂孔面积(最大Valsalva动作)均高于剖宫产孕妇(P<0.05);疗效不佳的PFD患者治疗前的尿道旋转角、膀胱后角、膀胱移动度、肛提肌裂孔面积(最大Valsalva动作)均高于疗效良好的患者(P<0.05)。治疗前尿道旋转角、膀胱后角、膀胱移动度、肛提肌裂孔面积(最大Valsalva动作)预测PFD患者盆底康复疗效不佳的曲线下面积(AUC)分别为0.821、0.771、0.732、0.703。结论经会阴盆底超声参数可监测PFD病情,且能为临床预测盆底康复疗效、判断疾病转归提供参考。

腹腔镜子宫肌瘤剔除术对子宫肌瘤患者盆底功能、卵巢功能的影响

目的探讨腹腔镜子宫肌瘤剔除术(LM)对子宫肌瘤患者盆底功能、卵巢功能的影响。方法纳入2021年1月至2022年10月濮阳市安阳地区医院收治的80例子宫肌瘤患者,按抽签法分两组。对照组40例行开腹子宫肌瘤剔除术(AM),研究组40例行LM,对比两组手术前后疼痛因子[心肌细胞P物质(SP)、前列腺素E_2(PGE_2)]、应激反应指标[去甲肾上腺素(NE)、皮质醇(COR)]、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、盆底功能指标[盆底障碍影响简易问卷7(PFIQ-7)]及卵巢功能指标[雌二醇(E_2)、促黄体生成素(LH)、促卵泡激素(FSH)]。结果术后1 d、术后3 d时,研究组血清SP、PGE_2、NE、COR水平低于对照组,差异有统计学意义(P<0.05)。术后1d时,两组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)功能指标与术前相比均有所降低,但研究组明显高于对照组,差异有统计学意义(P<0.05);而两组的CD8^(+)功能指标与术前相比有所升高,但研究组明显低于对照组,差异有统计学意义(P<0.05)。术后1个月、术后3个月时,两组PFIQ-7评分均有所升高,但研究组明显低于对照组,差异有统计学意义(P<0.05)。术后3个月、术后6个月时,研究组血清E_2水平高于对照组,而血清LH、FSH水平低于对照组,差异有统计学意义(P<0.05)。结论对子宫肌瘤患者行LM可有效减轻机体疼痛程度、应激反应及对免疫、盆底和卵巢功能的负面影响,优势较为显著,具有进一步的使用价值。

女性盆底功能障碍性疾病诊治流程及物理康复技术临床应用——临床应用及实践

盆底肌训练、生物反馈、电刺激、磁刺激、射频、激光等物理康复技术现已证实在女性盆底功能障碍性疾病(FPFD)的临床治疗中有一定疗效,且在相关类型FPFD诊治指南中获得一定推荐或不同强度证据支持。物理康复技术相关参数在同一种FPFD的治疗中虽不具有一致性,但均在一定参数范围内。本综述旨在探究物理康复技术的相关循证依据,对重点类型FPFD推荐相应物理参数的物理治疗,从而对不同类型物理治疗技术在FPFD的治疗提供借鉴和依据。

女性盆底功能障碍性疾病诊治流程及物理治疗康复临床应用——康复流程、原则及智能诊疗

女性盆底功能障碍性疾病(FPFD)发生机制复杂,专科的临床医师往往无法覆盖妇产、泌尿、肛肠、影像等各专科全面的医学专业信息,限制了对于该疾病的系统、全面诊治。FPFD的治疗需要遵循康复流程,制定个性化物理治疗干预措施,同时结合其他方式制定综合性治疗策略。人工智能在盆底领域的应用,不仅可以提高医生诊断效率,还可以为综合治疗方案的制定提供参考和依据,实现智能诊疗与精准医疗。本文从FPFD康复流程出发,分析康复原则及内容,探究人工智能在FPFD诊疗中的应用现状,旨在为实现盆底疾病智能诊疗提供参考。

基于MRI及DTI双模态成像技术在盆底肌功能障碍诊断中的临床价值

目的 探究基于磁共振成像(MRI)及扩散张量成像(DTI)双模态成像技术在盆底肌功能障碍(PFD)诊断中的临床价值。方法选取喀什地区第一人民医院收治的50例PFD患者作为研究对象并纳入PFD组,另选取同期于医院体检的30例正常志愿者作为对照,纳入对照组,两组均采用MRI及DTI双模态成像技术进行检查,比较两组患者临床资料、盆底肌扫描面积(髂骨尾骨肌、耻骨尾骨肌、耻骨直肠肌)、肛提肌裂孔宽度、盆底标志线(H线、M线)、髂骨尾骨肌厚度(ICT)、髂骨尾骨肌角(ICA)及肛提肌角(LPA),髂骨尾骨肌、耻骨直肠肌各向异性分数(FA)及表观弥散系数(ADC)值。结果两组一般资料比较在统计学上无显著性差异(P>0.05);PFD组静态与动态髂骨尾骨肌、耻骨尾骨肌、耻骨直肠肌面积均小于对照组(P<0.05);PFD组静态与动态肛提肌裂孔宽度大于对照组,H线、M线长于对照组(P<0.05);PFD组ICT少于对照组,LPA大于对照组,两组ICA比较在统计学上无显著性差异(P>0.05);两组髂骨尾骨肌、耻骨直肠肌FA、ADC值比较在统计学上无显著性差异(P>0.05)。结论基于MRI及DTI双模态成像技术可反映PFD患者盆底功能及形态变化,在PFD患者中具有良好的应用价值,可用于临床推广。

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。

经会阴盆底超声定量评估围绝经期子宫全切术后近期盆底功能的价值

目的经会阴盆底超声动态观察围绝经期子宫切除术后盆底结构变化,并定量评估其近期盆底功能。方法选择2021年1月—2023年3月在徐州市妇幼保健院超声科因子宫良性病变行子宫全切术后1年内复查的62例患者作为观察者设为子宫切除组,年龄40~55岁,术前未绝经,术前无盆腔手术史,术前临床未诊断盆底功能障碍性疾病(pelvic floor dysfunction,PFD);选择同期在本院经会阴盆底超声检查前临床未诊断PFD的61名女性作为对照组,年龄40~54岁,未绝经,无盆腔手术史。所有检查者均由科室2名盆底研究方向副主任医师随机分配操作检查。所有受检者行经会阴盆底超声检查,在标准切面上测量膀胱逼尿肌厚度、静息状态及最大Valsalva状态下膀胱颈距离耻骨联合后下缘距离(X)、膀胱尿道后角(β)、直肠壶腹最低点距耻骨联合后下缘距离(D),观察尿道内口漏斗形成,计算尿道旋转角(Ra)及膀胱颈下降值(bladder neck descent,BND),并观察前后盆腔有无器官脱垂及程度。结果子宫切除组患者年龄较对照组大,有统计学意义(P<0.05),X、D值均减小,差异均有统计学意义(P<0.05);而Ra、β、BND、膀胱逼尿肌厚度及裂孔面积比较差异均无统计学意义(P>0.05);子宫切除组与对照组发生PFD的情况比较,仅直肠脱垂差异有统计学意义(P<0.05),压力性尿失禁(stress urinary incontinence,SUI)、膀胱脱垂、盆腔器官脱垂(pelvic organ prolapse,POP)总计及PFD总计比较差异均无统计学意义(P>0.05)。结论经会阴盆底超声可对围绝经期子宫切除术后盆底结构动态观察,并进行定量评估;子宫切除术对围绝经期女性后盆腔盆底功能影响较大。

高分辨率MRI对盆底功能障碍性疾病患者子宫形态改变的评估价值

目的探讨高分辨率MRI对盆底功能障碍性疾病患者子宫形态改变的评估应用价值,以期为临床诊断该疾病提供参考和依据。方法本研究中共纳入83例盆底功能障碍性疾病患者,所有患者均来源于河南科技大学第二附属医院,选取时间为2020年10月至2022年10月,均经手术确诊,设为研究组,另于同一时间段选择于本院进行健康体检的80例研究对象,设为参照组,进行回顾性分析。所有研究对象均于术前接受高分辨率MRI及会阴实时三维超声扫描。将两组研究对象应用高分辨率MRI检查的各项指标、应用三维超声检查的各项指标,以及盆底肌厚度进行对比。结果研究组患者膀胱颈下降、子宫颈下降、肛管直肠连接下降各项数值均比参照组研究对象升高(均P<0.05);研究组患者膀胱移动度、Valsalva盆膈裂孔面积均相较于参照组上升,子宫后位占比为71.08%,相较于参照组的28.80%升高,子宫前位占比为28.92%,相较于参照组的71.25%下降(均P<0.05);经对比,参照组和研究组研究对象左右侧耻骨直肠肌、髂骨尾骨肌厚度对比,均有统计学差异,其中研究组患者左、右侧耻骨直肠肌、髂骨尾骨肌厚度均比参照低,且两组研究对象之间对比,左侧耻骨直肠肌、髂骨尾骨肌厚度均比右侧升高(均P<0.05)。结论盆底功能障碍性疾病患者接受高分辨率MRI检查和会阴三维实时超声检查均可为该疾病的诊断提供参考和依据,且高分辨率MRI检查具有较高的应用价值,临床在对盆底功能障碍性疾病患者诊断时,可首选会阴三维实时超声检查方法,而对于行上述检查未见明显征象的患者,可行高分辨率MRI检查,从而提升诊断的准确率。