电刺激联合盆底功能训练治疗产后盆底功能障碍的临床研究  

Clinical research of electrical stimulation combined with pelvic floor function training for the treatment of postpartum pelvic floor dysfunction

作　　者：张艳[1] 马娜[1] 邹红霞 ZHANG Yan;MA Na;ZOU Hongxia(Department of Gynaecology and Obstetrics,Yan′an People′s Hospital,Shaanxi Province,Yan′ an,716000,China;the First Department of Obstetrics,Northwest Women and Children Hospital,Shaanxi Province,Xi′an,710061,China)

机构地区：[1]陕西省延安市人民医院妇产科,陕西延安716000 [2]西北妇女儿童医院产一科,陕西西安710061

出　　处：《中国医药导报》2018年第33期60-63,67,共5页China Medical Herald

基　　金：陕西省科学技术研究发展计划项目(2015SF257)

摘　　要：目的探讨电刺激联合盆底功能训练治疗产后盆底功能障碍(PFD)的临床效果。方法选择2016年10月～2017年11月入住延安市人民医院的89例分娩产妇为研究对象,采用随机数字表法将其分为对照组(n=44)和研究组(n=45)。对照组产妇采用产后基础护理+盆底功能训练,研究组产妇在对照组基础上联合电刺激治疗。治疗后统计两组临床总有效率;治疗前后检查两组产妇阴道肌力、女性性功能指数(FSFI)和尿动力学指标;观察两组产妇产后6个月的预后情况。结果研究组产妇的临床总有效率高于对照组(P <0.05)。与治疗前比较,两组产妇治疗后盆底Ⅰ类肌纤维和Ⅱ类肌纤维的持续收缩压和收缩持续时间、FSFI评分、最大尿流率(Qmax)和最大尿道压均明显升高(P <0.05),而排尿时间明显缩短(P <0.05);研究组产妇治疗后阴道肌力、FSFI及尿动力学指标改善情况均明显优于对照组(P <0.05);研究组产妇的子宫脱垂、尿失禁、性功能障碍及PFD的发生率均明显低于对照组(P <0.05)。结论电刺激联合盆底功能训练能有效治疗PFD,不仅可以改善产妇的性生活质量、阴道肌力及尿动力学指标,而且预后良好,值得在临床上大力推广。Objective To explore the clinical effect of electrostimulation combined with pelvic floor function training for postpartum pelvic floor dysfunction （PFD）. Methods From October 2016 to November 2017, 89 puerperas who were admitted to Yan′an People′s Hospital were selected as study objects, and they were divided into control group （n = 44） and research group （n = 45） according to random number table method. Puerperas in the control group were trained with postpartum basic nursing and pelvic floor function, while the puerperas of research group were treated with electrical stimulation on the basis of control group. The clinical total effective rate of two groups after treatment were counted, the vaginal muscle strength of two groups before and after the treatment were detected, the female sexual function index （FSFI） and urine dynamics index of two groups before and after the treatment were detected. In addition, the prognosis of two groups 6 months after delivery were observed. Results The total clinical effective rate of the study group was higher than that of the control group （P 〈 0.05）; compared with before treatment, the sustained systolic blood pressure and duration of the contraction of muscle fiber of pelvic floor type Ⅰ and type Ⅱ, FSFI score, Qmax and MUP of two groups after treatment significantly elevated （P 〈 0.05）, while VT was shorten significantly （P 〈 0.05）. The improvement of vaginal muscle, FSFI and urine dynamics index of research group after treafment were better than that of the control group （P 〈 0.05）. The incidence of uterine prolapse, urinary incontinence, sexual dysfunction and PFD of the research group were significantly lower than that of the control group （P 〈 0.05）. Conclusion Electrostimulation combined with pelvic floor function training can effectively treat PFD, which not only improve the quality of maternal sex, vaginal muscle strength and urine dynamics index, but also have a good prognosis. It is worthy of clinical applicati

关 键 词：电刺激 盆底功能训练 产后盆底功能障碍 临床效果 

分 类 号：R711.5[医药卫生—妇产科学]