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.

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.

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.

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.

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.

盆底四维超声评估电刺激生物反馈治疗PFD患者的效果分析

目的探讨盆底四维超声检查女性盆底肌功能障碍(PFD)患者经电刺激生物反馈治疗的应用价值。方法选取68例PFD患者,均开展电刺激生物反馈治疗,于治疗前后应用盆底四维超声进行检查,评估患者的临床效果。结果治疗后盆底肌力及盆底肌收缩压均高于治疗前,且1 h尿垫试验数据低于治疗前(P<0.05)。治疗后患者静息时、Valsalva动作时的提肛肌厚度高于治疗前,肛提肌裂孔左右径、肛提肌裂孔面积、膀胱后角均低于治疗前(P<0.05)。治疗后膀胱颈移动度及尿道旋转角均低于治疗前(P<0.05)。结论经电刺激生物反馈治疗前后应用盆底四维超声进行检查PFD患者能够有效明确机体的实际情况,进一步了解盆底肌功能,可为临床治疗提供科学依据。

PFD患者及正常女性盆底解剖结构的MRI研究

目的对比分析盆底功能障碍性疾病(pelvic floor dysfunction,PFD)患者及正常女性盆底解剖结构的MRI表现。方法选取我科2012年6月至2014年6月确诊为PFD的患者40例。同时选取健康同龄女性志愿者40例作为对照组。通过行静动态核磁共振扫描(MRI)评价两组的肛提肌指标、盆腔各器官脱垂情况、尿道长度和尿道周围支持结构指标。结果PFD组耻尾肌面积、髂尾肌面积和耻直肌面积的静/动态测量值显著低于正常组。PFD组提肌板角、盆膈裂孔横径、LH线和M线的静/动态测量值分别为,显著高于正常组的。PFD组静态和动态期的膀胱颈、子宫颈和肛直肠连接均显著重于正常组,P<0.05。结论 PFD患者在MRI所成图像中盆底解剖结构和正常女性差异较大,盆腔动静态磁共振在PFD诊断和评估中具有重要应用价值。

盆底肌肉锻炼结合神经肌肉刺激对PFD者RLX、TIMP-2及ET-1的影响

目的 分析盆底肌肉锻炼结合神经肌肉刺激对初产妇产后盆底功能障碍性疾病(PFD)松弛素(RLX)、金属蛋白酶组织抑制因子-2(TIMP-2)及内皮素-1(ET-1)的影响。方法 收集2017年5月至2020年5月衡水市第二人民医院收治的125例PFD患者,根据不同治疗方式分为联合组(盆底肌肉锻炼+神经肌肉刺激)68例、对照组(神经肌肉刺激)57例。比较两组治疗前后3个月盆底肌情况、盆腔松弛因子[RLX、转化生长因子-β3(TGF-β3)、层粘连蛋白(LN)]、TIMP-2、基质金属蛋白酶-2(MMP-2)、一氧化氮(NO)、ET-1、炎性因子[C反应蛋白(CRP)、白介素-6(IL-6)]变化。结果 治疗后联合组总肌电值、Ⅰ类、Ⅱ类肌纤维肌电值均高于对照组,差异有统计学意义(P<0.05)。治疗后联合组RLX、TGF-β3及LN低于对照组,差异有统计学意义(P<0.05)。治疗后联合组MMP-2水平明显低于对照组,TIMP-2高于对照组,差异有统计学意义(P<0.05)。治疗后两组NO水平均上升,炎性因子、ET-1水平下降,且联合组NO水平明显高于对照组,CRP、IL-6、ET-1水平明显低于对照组,差异有统计学意义(P<0.05)。结论 盆底肌肉锻炼结合神经肌肉刺激可有效改善PFD患者盆底功能障碍,降低RLX、ET-1水平,提高TIMP-2表达,临床使用价值高。

TPUS检查对子宫全切术后患者PFD发生情况的评估价值

本文旨在分析经会阴超声(TPUS)检查对子宫全切术后患者盆底功能障碍(PFD)发生情况的评估价值。选取行子宫全切术的患者157例,根据术后是否出现PFD,分为未发生PFD组103例和发生PFD组54例,均行TPUS检查。结果显示,与未发生PFD组相比,发生PFD组膀胱下移距离、直肠下移距离、阴道穹窿下移距离、膀胱尿道后角、肛提肌裂孔左右径、前后径、面积、周长升高,尿道倾斜角降低(P<0.05)两组肛提肌厚度比较,差异无统计学意义(P>0.05)。与经会阴二维、三维、四维超声检查单独检查相比,三项联合诊断价值较高(P<0.05)。研究结果表明,子宫全切术患者术后存在PFD,TPUS检查对PFD的诊断价值较为理想,可用于子宫全切术后患者PFD发生的临床诊断评估。

不同时间段生物反馈电刺激结合盆底手法按摩对PFD患者盆底肌力及电生理的影响

目的探索不同时间段生物反馈结合盆底手法按摩对盆底功能障碍性疾病(pelvic floor dysfunction,PFD)患者盆底肌力和电生理的影响。方法选择PFD患者232例为研究对象,按照产后就诊并接受治疗时间段分为A组(产后6周~3个月内接受治疗)135例,B组(产后3~6个月内接受治疗)63例,C组(产后6个月~1年内接受治疗)34例。3组均接受1个疗程生物反馈电刺激及盆底手法按摩的联合治疗后,比较3组盆底肌力改变情况、PFD症状改善情况和电生理情况。结果治疗后,A组、B组Ⅰ类纤维肌力、Ⅱ类纤维肌力高于治疗前;且A组、B组盆底肌力高于C组(P<0.05)。A组、B组压力性尿失禁发生率低于治疗前,A组阴道前壁脱垂、子宫脱垂发生率低于治疗前;A组阴道前壁脱垂发生率低于B组和C组(P<0.05)。A组、B组Ⅰ类肌纤维疲劳度、Ⅱ类肌纤维疲劳度低于治疗前,阴道动态压力、A3反射正常率高于治疗前;A组和B组Ⅰ类纤维疲劳度、Ⅱ类纤维疲劳度低于C组,A3反射正常率高于C组(P<0.05)。结论PFD患者在产后6周~3个月接受生物反馈电刺激和手法按摩治疗效果最好,病程越长,治疗效果越差,需要后续进一步治疗。

围绝经期PFD患者阴道脱落细胞成熟度、E_(2)和25⁃(OH)⁃D与LGR7 mRNA的关系

目的探究围绝经期盆底功能障碍性疾病(PFD)患者阴道脱落细胞成熟度、雌激素(E_(2))和25羟基维生素D[25⁃(OH)⁃D]与阴道壁松弛素受体(LGR7)信使核糖核酸(mRNA)的关系。方法选取2020年9月至2022年9月于廊坊市人民医院就诊的围绝经期PFD患者42例,围绝经期健康女性38名,计算阴道脱落细胞成熟指数,检测血清E_(2)、25⁃(OH)⁃D水平以及阴道壁组织LGR7 mRNA相对表达量,分析LGR7 mRNA与其余指标的相关性。结果观察组绝经率、盆底肌静息肌电值、合并阴道炎率、LGR7 mRNA表达水平高于对照组,盆底肌最大收缩力、持续收缩力、阴道脱落细胞成熟度、E_(2)和25⁃(OH)⁃D水平低于对照组,差异均有统计学意义(P<0.05);阴道脱落细胞成熟度、E_(2)和25⁃(OH)⁃D均与盆底肌力呈正相关(P<0.05),LGR7 mRNA与盆底肌力,阴道脱落细胞成熟度、E_(2)和25⁃(OH)⁃D与LGR7 mRNA呈负相关(P<0.05);阴道脱落细胞成熟度、E_(2)、25⁃(OH)⁃D、LGR7 mRNA的曲线下面积分别为0.918、0.919、0.898、0.858(P<0.05);阴道脱落细胞成熟度<58.95%、E_(2)<65.76 pmol/L、25⁃(OH)⁃D<28.19μg/L、LGR7 mRNA>0.58为围绝经期PFD的危险因素(P<0.05)。结论围绝经期PFD患者阴道脱落细胞成熟度、E_(2)和25⁃(OH)⁃D与LGR7 mRNA呈负相关,上述指标均对PFD的诊断具有一定参考价值。

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.

盆底肌训练联合生物反馈电刺激对产后PFD患者盆底肌力及器官脱垂程度的影响

目的:探讨盆底肌训练联合生物反馈电刺激对产后盆底功能障碍(PFD)患者盆底肌力、盆底器官脱垂(POP)程度及生命质量的影响。方法:选取某院2018年8月-2020年9月期间97例产后盆底功能障碍患者作为研究对象,采用随机数字表法分为对照组48例和观察组49例,对照组采用产后盆底肌训练,观察组在此基础上联合生物反馈电刺激疗法,观察两组患者的临床效果,盆底肌力,POP程度以及生命质量。结果:两组患者干预后的临床效果,观察组总有效率97.95%明显优于对照组81.25%(χ^(2)=7.32(P<0.05));干预后两组患者的盆底肌力,观察组改善程度显著优于对照组(P<0.05);两组患者干预后的POP-Q程度0度、Ⅰ度以及Ⅱ度,观察组恢复程度明显优于对照组(χ^(2)=17.18、7.64、6.27(P<0.05));干预后两组患者生命质量,观察组改善程度高于对照组(P<0.05)。结论:盆底肌训练联合生物反馈电刺激干预产后PFD患者效果确切,能通过刺激盆底肌肉收缩以及增强盆底功能弹性程度等有效改善其盆底肌力、POP程度及生命质量,值得临床推广及其应用.

产后盆底神经肌肉电刺激生物反馈联合Kegel运动对PFD病情转归的影响

目的探讨产后盆底神经肌肉电刺激生物反馈联合凯格尔(Kegel)运动对盆底功能障碍(PFD)患者病情转归的影响。方法选择2019年8月至2020年12月肇庆市高要区人民医院收治的120例产后早期盆底功能障碍患者为研究对象,根据随机数表法分为观察组和对照组各60例。对照组实施Kegel运动训练,观察组实施盆底神经肌肉电刺激生物反馈联合Kegel运动训练。比较两组患者治疗后6个月的疗效、治疗前及治疗后6个月的肌纤维肌力评分、盆底功能障碍评分(PFDI-20)、盆底功能影响评分(PFIQ-7)、尿动力学[排尿时间(VT)、最大尿道压(MUP)、最大尿流率(Qmax)]指标,同时比较两组患者的并发症发生情况。结果治疗后6个月,观察组患者的总有效率为98.33%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后6个月,观察组患者的Ⅰ类、Ⅱ类肌纤维肌力评分分别为(10.33±0.29)分、(12.04±0.46)分,明显高于对照组的(8.56±0.28)分、(10.01±0.47)分,PFDI-20、PFIQ-7评分、VT分别为(10.94±2.06)分、(10.12±2.04)分、(32.44±2.53)s,明显低于对照组的(18.05±3.77)分、(19.81±3.05)分、(37.01±2.49)s,MUP、Qmax分别为(86.02±4.35)cmH_(2)O、(27.30±5.11)mL/s,明显高于对照组的(79.17±4.08)cmH_(2)O、(23.27±5.45)mL/s,差异均有统计学意义(P<0.05);观察组并发症发生率为5.00%,明显低于对照组的26.67%,差异有统计学意义(P<0.05)。结论盆底神经肌肉电刺激生物反馈联合Kegel运动训练应用于产后早期盆底功能障碍能有效改善患者的盆底肌力和尿动力学指标,提高生活质量,临床应用效果显著,并发症低,值得推广使用。

盆底电刺激联合盆底康复对PFD的疗效观察

目的探究盆底电刺激联合盆底康复对产后盆底功能障碍(pevic floor disfunction,PFD)的疗效。方法选取2019年1月—2020年1月于本院收治的120例产后PFD患者为研究对象,使用随机数字表法分为对照组和联合组,两组患者各60例。联合组患者进行盆底电刺激联合盆底康复干预,对照组患者仅予以盆底康复干预。比较两组患者干预前及干预8周后盆底肌力[国际会阴肌力测试法(GRRUG)]。结果干预8周后,两组患者GRRUG得分较干预前上升,且联合组高于同期对照组(P<0.05)。结论盆底电刺激联合盆底康复干预可促进产后PFD患者盆底肌力改善。

经会阴实时三维超声测定valsalva动作盆膈裂孔面积对FPFD诊断及术后疗效预测价值

目的:探讨经会阴实时三维超声测定valsalva动作盆膈裂孔面积对女性盆底功能障碍(female pelvic floor dysfunction,FPFD)病人的诊断及对病人术后疗效的预测价值。方法:选取行Prolift手术治疗的62例FPFD病人为研究对象,同时以60例无FPFD症状的阴道三维超声检查者作为对照组。对所有研究对象进行经会阴实时三维超声探查其子宫位置形态、膀胱颈移动度(BND)、valsalva动作盆膈裂孔面积,采用受试者工作特征曲线(ROC)分析三维超声对FPFD病人的诊断价值。比较FPFD组病人手术前后最大Valsalva状态下盆膈裂孔面积、周长、前后径、左右径,探讨会阴实时三维超声对手术疗效的评估和预测价值。结果:FPFD组病人子宫后位比例、BND、valsalva动作盆膈裂孔面积均高于对照组(P<0.01)。以病人是否诊断为FPFD作为二分类变量(否=0,是=1),对BND、valsalva动作盆膈裂孔面积诊断FPFD价值进行ROC曲线分析,结果显示BND诊断截断值为21.65 mm,预后诊断曲线下面积为0.814(95%CI:0.766~0.862),灵敏度为70.97%,特异度为75.00%;valsalva动作盆膈裂孔面积截断值为20.25 cm 2,预后诊断曲线下面积为0.867(95%CI:0.829~0.906),灵敏度为82.26%,特异度为70.00%,具有更高的诊断效能。FPFD组病人行Prolift手术3个月后的治愈率为91.94%(57/62),复发率为8.06%(5/62)。且病人术后3个月的盆膈裂孔面积、周长、前后径、左右径相较于术前均明显降低(P<0.01)。结论:经会阴实时三维超声可以提供valsalva动作盆膈裂孔面积等盆底解剖信息,在诊断FPFD方面具有重要价值;同时可以帮助医生掌握病人盆底恢复情况,可应用于病人术后疗效预测。

裸燕麦麸皮提取物和低频脉冲刺激干预PFD大鼠对ArfGAP3通路的影响

目的:分析裸燕麦麸皮提取物和低频脉冲刺激分别干预盆底功能障碍(PFD)大鼠对ADP核糖基化因子GTP结合蛋白3(ArfGAP3)信号通路的影响。方法:将30只大鼠随机均分为模型组、药物干预组、物理干预组,比较各组干预后病灶局部组织中ArfGAP3、透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原蛋白(Ⅳ-C)含量的统计学差异。用回归模型分析HA、LN、Ⅳ-C和ArfGAP3的综合关联。结果:药物干预组和模型组、物理干预组和模型组、物理干预组和药物干预组两两比较,各指标差异均有统计意义(P<0.05)。各指标对ArfGAP3蛋白影响程度依次为LN蛋白、HA蛋白、Ⅳ-C蛋白。结论:低频脉冲刺激和裸燕麦麸皮提取物虽然均能对PFD大鼠病灶局部ArfGAP3通路产生激活作用,但低频脉冲刺激物理治疗方式能更为快捷且显著的降低LN蛋白表达,增加HA、Ⅳ-C蛋白表达,可能对病灶局部肌功能恢复有更好促进作用。

Kegel运动对高龄PFD患者盆底功能、氧化应激指标水平及预后的影响

目的探索Kegel运动对高龄盆底功能障碍(PFD)患者盆底功能、氧化应激指标水平及预后的影响,以期为临床治疗提供参考。方法选取2019年11月—2021年2月在河南省平顶山市妇幼保健院就诊的115例PFD高龄产妇(产后42 d诊断为PFD)作为研究对象,采用随机数字表法将患者分为传统组(n=57)和Kegel组(n=58)。传统组患者采用传统盆底肌锻炼。Kegel组患者采用Kegel运动。比较2组患者治疗前、治疗6个月时盆底功能及丙二醛(MDA)、谷胱甘肽(GSH)、超氧化物歧化酶(SOD)水平。比较2组患者治疗6个月时不良结局发生情况。结果治疗前,2组患者阴道肌电压、阴道动态压、盆底肌力水平比较,差异无统计学意义(P>0.05)。治疗6个月时,2组患者阴道肌电压、阴道动态压、盆底肌力水平均高于治疗前,且Kegel组高于传统组,差异均有统计学意义(P<0.05)。治疗前,2组患者MDA、GSH及SOD水平比较,差异无统计学意义(P>0.05)。治疗6个月时,2组患者MDA水平均低于治疗前,且Kegel组低于传统组,差异均有统计学意义(P<0.05)。治疗6个月时,2组患者GSH及SOD水平均高于治疗前,且Kegel组高于传统组,差异均有统计学意义(P<0.05)。Kegel组患者中子宫脱垂、压力性尿失禁、腰骶酸痛、阴道松弛率、阴道干涩发生率均低于传统组,差异均有统计学意义(P<0.05)。结论Kegel运动应用于PFD患者治疗中,可增强阴道肌张力,改善氧化应激指标,调节盆底功能,改善患者临床预后,效果显著,值得临床推广应用。