经阴道子宫切除术+阴道前后壁修补术配合盆底训练对子宫脱垂患者盆底功能恢复情况的影响观察  

Effect of transvaginal hysterectomy plus anterior and posterior vaginal wall repair combined with pelvic floor training on the postoperative recovery of pelvic floor function in patients with uterine prolapse

作　　者：王丽芳 陈玉兰 黄霄行 黄方 何瑞兴 Wang Lifang;Chen Yulan;Huang Xiaoxing;Huang Fang;He Ruixing(Department of Nosocomial Infection Control,Houjie Hospital,Dongguan,Guangdong 523960,China;Department of Gynecology,Houjie Hospital,Dongguan,Guangdong 523960,China;Department of Prevention and Healthcare,Houjie Hospital,Dongguan,Guangdong 523960,China)

机构地区：[1]厚街医院院感科,广东东莞523960 [2]厚街医院妇科,广东东莞523960 [3]厚街医院防保科,广东东莞523960

出　　处：《广州医科大学学报》2021年第5期106-109,120,共5页Academic Journal of Guangzhou Medical University

基　　金：东莞市社会科技发展(一般)项目(编号:202050715023707)。

摘　　要：目的:探究经阴道子宫切除术+阴道前后壁修补术配合盆底训练对子宫脱垂患者盆底功能恢复情况的影响。方法:选取东莞市厚街医院2019年1月至2021年7月收治的子宫脱垂患者60例,采用随机数表法将其分为对照组与观察组,各30例。两组均接受经阴道子宫切除术+阴道前后壁修补术治疗,术后对照组行常规盆底康复训练,观察组患者配合盆底肌肉康复系统进行盆底肌康复训练,对比分析两组手术前后盆底功能障碍简表(PFDI-20)得分情况、治疗效果、盆底肌力以及盆底肌电情况的差异性。结果:术后3个月,两组的PFDI-20得分比较均较术前下降(P<0.05),且观察组下降幅度大于对照组(P<0.05)。术后1年,观察组的治疗有效率为93.33%,高于对照组的73.33%(P<0.05)。术后6个月,观察组患者的盆底Ⅰ、Ⅱ类肌纤维肌电压均高于对照组(P<0.05)。术后6个月,两组的盆底快速收缩值、紧张收缩值以及耐力测试值均较术前升高(P<0.05),且观察组上述指标均高于对照组(P<0.05)。结论:将经阴道子宫切除术+阴道前后壁修补术配合盆底训练应用于子宫脱垂患者中,能够有效缓解患者盆底功能障碍性症状,促进其盆底肌力恢复,改善盆底肌电,中远期临床效果良好。Objective:To investigate the effect of transvaginal hysterectomy plus anterior and posterior vaginal wall repair combined with pelvic floor training on the recovery of pelvic floor function in patients with uterine prolapse.Methods:A total of 60 patients with uterine prolapse admitted to Dongguan Houjie Hospital between January 2019 and July 2021 were enrolled and divided into the control group and the study group by random number table(n=30 each).The both groups underwent transvaginal hysterectomy plus anterior and posterior vaginal wall repair.The control group was given conventional pelvic floor rehabilitation training,and the study group received pelvic floor rehabilitation training with a pelvic floor muscle rehabilitation system.The two groups were compared for differences in scores of pelvic floor distress inventory 20(PFDI-20),treatment outcome,pelvic floor muscle strength,and pelvic floor electromyography(EMG)before and after surgery.Results:At three months after surgery,the PFDI-20 score in the either group was lower than baseline(P<0.05),and the reduction was greater in the study group than that in the control group(P<0.05).At one year after surgery,the rate of effective treatment in the study group was 93.33%,which was higher than 73.33% in the control group(P<0.05).At six months after surgery,the types I and II muscle fibers of the pelvic floor in the study group showed higher EMG amplitudes compared those in the control group(P<0.05).At six months after surgery,the EMG amplitudes with quick contraction,straining and endurance in either group were higher than baseline(P<0.05),and the improvement in these values was greater in the study group compared with the control group(P<0.05).Conclusion:Transvaginal hysterectomy plus anterior and posterior vaginal wall repair combined with pelvic floor training in patients with uterine prolapse can effectively relieve the symptoms of pelvic floor dysfunction,promote recovery of pelvic floor muscle strength,and improve pelvic floor electromyography,with favorable

关 键 词：子宫脱垂 经阴道子宫切除术 阴道前后壁修补术 盆底肌肉康复训练 生物反馈电刺激 

分 类 号：R711.2[医药卫生—妇产科学]