盆底肌肉訓(xùn)練對產(chǎn)后盆底功能障礙的效果分析(1)
[摘要] 目的 分析盆底肌肉訓(xùn)練對產(chǎn)婦產(chǎn)后盆底功能障礙的臨床效果。 方法 選取2012年10月～2014年12月在本院分娩產(chǎn)婦，隨訪確診為盆底功能障礙患者480例，隨機分為觀察組與對照組，每組240例。觀察組患者產(chǎn)后6周開始接受盆底肌肉訓(xùn)練，采用法國PHENIX盆底康復(fù)訓(xùn)練系統(tǒng)治療儀進行生物反饋及電刺激治療，同時給予常規(guī)盆底肌肉訓(xùn)練指導(dǎo)，對照組給予常規(guī)盆底肌肉訓(xùn)練指導(dǎo)和健康教育。觀察兩組患者治療效果。 結(jié)果 觀察組患者盆底肌力治療有效226例，有效率為94.17%，子宮脫垂治療有效76例，有效率為90.48%，尿失禁治療有效119例，有效率為95.97%。對照組患者盆底肌力治療有效182例，有效率為75.83%，子宮治療有效脫垂53例，有效率為60.92%，尿失禁治療有效84例，有效率為70.00%。觀察組盆底肌力治療有效率、子宮脫垂治療有效率及尿失禁治療有效率均明顯高于對照組，差異有統(tǒng)計學(xué)意義(P<0.05)。觀察組治療后手測盆底肌力為(4.04±0.35)級，盆底Ⅰ類肌纖維肌電壓為(8.08±1.56)μV，盆底Ⅱ類肌纖維肌電壓為(8.11±1.51)μV，盆底Ⅰ類肌纖維疲勞度為(-0.02±0.02)%，盆底Ⅱ類肌纖維疲勞度為(0±0.01)%。對照組治療后手測盆底肌力為(3.32±0.41)級，盆底Ⅰ類肌纖維肌電壓為(5.05±1.24)μV，盆底Ⅱ類肌纖維肌電壓為(5.42±1.33)μV，盆底Ⅰ類肌纖維疲勞度為(-0.04±0.02)%，盆底Ⅱ類肌纖維疲勞度為(-0.01±0.02)%。觀察組盆底肌力各項指標均明顯優(yōu)于對照組，差異有統(tǒng)計學(xué)意義(P<0.05)。 結(jié)論 盆底肌力訓(xùn)練對改善產(chǎn)后盆底功能障礙患者盆底肌力有顯著效果，對改善尿失禁與子宮脫垂情況也起到有效作用，臨床上值得推廣。
[關(guān)鍵詞] 盆底肌肉訓(xùn)練；盆底功能障礙；盆底肌力
[中圖分類號] R711 [文獻標識碼] A [文章編號] 1674-4721(2015)05(b)-0079-03
Efficacy analysis of pelvic floor exercise on postpartum pelvic floor dysfunction
QUE Gui-zhen
Department of Gynaecology and Obstetrics，Central Hospital of Kaiping City in Guangdong Province，Kaiping 529300，China
[Abstract] Objective To analyze and explore the clinical effect of pelvic floor exercise on postpartum pelvic floor dysfunction. Methods 480 patients who were delivered in our hospital from October 2012 to December 2014 and were definitely diagnosed as pelvic floor dysfunction were selected.They were evenly divided into two groups，observation group and control group in random.In observation group，patients were received with pelvic floor exercise 6 weeks after delivery.PHENIX pelvic floor rehabilitation exercise system equipment was applied for biological feedback and electrical stimulation therapy was also used.Meanwhile，guidance of regular pelvic floor exercise was provided.In control group， guidance of regular pelvic floor exercise and health education were supplied.The therapeutic effect between two groups was observed. Results In observation group，there were 226 effective cases in the treatment of pelvic floor muscle strength accounting for 94.17%，76 effective cases on treating uterine prolapse for 90.48%，and 119 effective cases in urinary incontinence accounting for 95.97%.In control group，they were 182(75.83%)，53(60.92%)，and 84(70.00%) respectively.Effective rates of pelvic floor muscle strength，uterine prolapse，and urinary incontinence in observation group was remarkably higher than that in control group respectively，with significant difference(P<0.05).After treatment，in observation group，pelvic floor muscle strength tested by hand was (4.04±0.35)，pelvic floor Ⅰ and Ⅱ muscle voltage of myofiber were[(8.08±1.56)，(8.11±1.51) μV]，and fatigue in Ⅰ and Ⅱ pelvic floor myofiber was(-0.02±0.02)% and (0±0.01)% in turn.In control group，after therapy，pelvic floor muscle strength tested by hand was(3.32±0.41).Muscle voltage of myofiber in pelvic floor Ⅰ and Ⅱ was[(5.05±1.24)，(5.42±1.33) μV] respectively.Fatigue of myofiber in pelvic floor Ⅰ and Ⅱ was(-0.04±0.02)% and (-0.01±0.02)% in turn.In observation group，every index of pelvic floor muscle strength was remarkably superior to that in control group，with significant difference(P<0.05). Conclusion Pelvic floor exercise obtains a remarkable effect on improvement of patients with postpartum pelvic floor dysfunction and is also effective on improving urinary incontinence and uterine prolapse，which is worthy of expansion in clinical. (闕貴珍)
[關(guān)鍵詞] 盆底肌肉訓(xùn)練；盆底功能障礙；盆底肌力
[中圖分類號] R711 [文獻標識碼] A [文章編號] 1674-4721(2015)05(b)-0079-03
Efficacy analysis of pelvic floor exercise on postpartum pelvic floor dysfunction
QUE Gui-zhen
Department of Gynaecology and Obstetrics，Central Hospital of Kaiping City in Guangdong Province，Kaiping 529300，China
[Abstract] Objective To analyze and explore the clinical effect of pelvic floor exercise on postpartum pelvic floor dysfunction. Methods 480 patients who were delivered in our hospital from October 2012 to December 2014 and were definitely diagnosed as pelvic floor dysfunction were selected.They were evenly divided into two groups，observation group and control group in random.In observation group，patients were received with pelvic floor exercise 6 weeks after delivery.PHENIX pelvic floor rehabilitation exercise system equipment was applied for biological feedback and electrical stimulation therapy was also used.Meanwhile，guidance of regular pelvic floor exercise was provided.In control group， guidance of regular pelvic floor exercise and health education were supplied.The therapeutic effect between two groups was observed. Results In observation group，there were 226 effective cases in the treatment of pelvic floor muscle strength accounting for 94.17%，76 effective cases on treating uterine prolapse for 90.48%，and 119 effective cases in urinary incontinence accounting for 95.97%.In control group，they were 182(75.83%)，53(60.92%)，and 84(70.00%) respectively.Effective rates of pelvic floor muscle strength，uterine prolapse，and urinary incontinence in observation group was remarkably higher than that in control group respectively，with significant difference(P<0.05).After treatment，in observation group，pelvic floor muscle strength tested by hand was (4.04±0.35)，pelvic floor Ⅰ and Ⅱ muscle voltage of myofiber were[(8.08±1.56)，(8.11±1.51) μV]，and fatigue in Ⅰ and Ⅱ pelvic floor myofiber was(-0.02±0.02)% and (0±0.01)% in turn.In control group，after therapy，pelvic floor muscle strength tested by hand was(3.32±0.41).Muscle voltage of myofiber in pelvic floor Ⅰ and Ⅱ was[(5.05±1.24)，(5.42±1.33) μV] respectively.Fatigue of myofiber in pelvic floor Ⅰ and Ⅱ was(-0.04±0.02)% and (-0.01±0.02)% in turn.In observation group，every index of pelvic floor muscle strength was remarkably superior to that in control group，with significant difference(P<0.05). Conclusion Pelvic floor exercise obtains a remarkable effect on improvement of patients with postpartum pelvic floor dysfunction and is also effective on improving urinary incontinence and uterine prolapse，which is worthy of expansion in clinical. (闕貴珍)