盆底肌训练联合神经肌电刺激治疗盆腔脏器脱垂的临床疗效  

Effects of pelvic floor muscle training combined with neuromuscular electrical stimulation in treatment of pelvic organ prolapse

作　　者：程慧[1] 成杰[1] 张蓓[1] 张艳玲[1] 李妍雨 Cheng Hui;Cheng Jie;Zhang Bei;Zhang Yanling;Li Yanyu(Department of Obstetrics and Gynecology,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu Province,China)

机构地区：[1]徐州市中心医院妇产科,江苏221009

出　　处：《中华妇幼临床医学杂志（电子版）》2020年第1期107-113,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：江苏省妇幼健康科研基金项目(F201662)。

摘　　要：目的探讨盆底肌训练(PFMT)联合神经肌电刺激(NMES)治疗,对盆腔脏器脱垂(POP)患者的临床疗效。方法选择2015年6月至2018年4月,于徐州市中心医院接受治疗的150例POP患者为研究对象。采用随机数字表法,将其分为观察组(n=80)及对照组(n=70)。对观察组患者采用PFMT联合NMES治疗,对照组患者仅采用PFMT治疗。采用《盆腔脏器脱垂/尿失禁性生活质量问卷(PISQ)-12》,评价患者性生活质量;采用《SF-36健康调查量表》,评价患者生活质量(QoL);采用神经肌电刺激治疗仪,评估患者盆底肌力;采用《汉密顿焦虑量表》(HAMA)及《汉密顿抑郁量表》(HAMD),评估患者焦虑及抑郁情况;采用腹部超声检查,评估患者POP程度。采用t检验或χ2检验,对2组POP患者治疗前及治疗1年时的上述相关指标,进行组内或组间比较。本研究遵循的程序经徐州市中心医院伦理委员会批准(审批文号:20150056),与所有受试者签署知情同意书。结果①性生活质量比较:观察组中经治疗后有性生活的POP患者治疗1年时PISQ-12评分为(24.5±8.0)分,显著高于其治疗前的(19.7±8.2)分,亦显著高于对照组中经治疗后有性生活的POP患者治疗1年时的(20.6±7.1)分,并且差异均有统计学意义(t=8.326、P=0.037,t=7.422、P=0.042)。②生活质量比较:治疗1年时,观察组POP患者生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、生理健康总评(PCS)、活力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)、心理健康总评(MCS)分值分别为(88.0±13.4)分、(91.9±22.6)分、(98.4±22.6)分、(88.1±9.5)分、(90.8±21.7)分、(92.1±19.6)分、(91.6±18.5)分、(92.1±21.6)分、(91.2±27.4)分、(91.9±14.5)分,均显著高于对照组POP患者的(71.6±8.5)分、(76.9±9.5)分、(73.8±12.1)分、(69.4±8.6)分、(79.1±10.3)分、(76.8±10.4)分、(75.5±11.7)分、(78.6±9.5)分、(75.2±11.6)分、(80.1±7.3)分,并且差异均有统计学差异(t=8.805、Objective To investigate the clinical effect of pelvic floor muscle training(PFMT)combined with neuromuscular electrical stimulation(NMES)on patients with pelvic organ prolapse(POP).Methods A total of 150 patients with POP who were treated in Xuzhou Central Hospital from June 2015 to April 2018,were chosen as research subjects.They were divided into observation group(n=80)and control group(n=70)according to random digits table method.Patients in observation group were treated with PFMT combined with NMES,while patients in control group were only treated with PFMT.Quality of sexual life was evaluated by Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire Short Form(PISQ)-12.Quality of life(QoL)of patients was evaluated by Mos 36-Item Short form Health Survey.The pelvic floor muscle strength of patients was evaluated by neuromuscular stimulation therapy apparatus.The anxiety and depression of patients were evaluated by Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD).The degree of POP of patients was evaluated by abdominal ultrasonography.The related indexes above mentioned before treatment and until one year of treatment of POP patients were compared intra-group or inter-group by t test or chi-square test.The study was carried out with the approval of Ethics Committee of Xuzhou Central Hospital(Approval No.20150056).All patients had informed consent to the study.Results①Comparison of quality of sexual life:PISQ-12 score of POP patients who had sexual life after treatment in observation group until one year of treatment was(24.5±8.0)scores,which was higher than that of(19.7±8.2)sores before treatment in observation group who had sexual life after treatment,also higher than that of(20.6±7.1)sores of POP patients in control group until one year of treatment,and the difference was statistically significant(t=8.326,P=0.037;t=7.422,P=0.042).②Comparison of QoL:the score of physiological function(PF),role physiological(RP),bodily pain(BP),general health(GH),physical component summary(PCS)

关 键 词：盆腔脏器脱垂 电刺激 骨盆底 肌组织 盆底肌训练 生活质量 焦虑 抑郁 疗效比较研究 女(雌)性 

分 类 号：R47[医药卫生—护理学]