不同康复方法治疗产后膀胱膨出患者的临床效果  

Clinical effect of different rehabilitation methods in the treatment of postpartum cystocele

作　　者：芦桂珍 LU Guizhen(Department of Obstetrics and Gynecology,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区江滨医院妇产科,广西南宁530021

出　　处：《妇儿健康导刊》2024年第7期190-194,共5页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：广西壮族自治区卫生健康委员会科研课题(Z20211147);广西壮族自治区中医药管理局科研课题(GXZYZ20210423)。

摘　　要：目的 观察不同康复方法治疗产后膀胱膨出患者的临床效果。方法 选取2021年7月至2023年7月在广西壮族自治区江滨医院就诊的160例产后膀胱膨出患者为研究对象,按照不同的康复治疗方法分为电刺激生物反馈疗法(ESBT)组、ESBT联合康复手法组、ESBT联合电针组及电针组四组,每组各40例。比较四组膀胱颈移动度、膀胱后角以及盆底肌功能。结果 四组治疗结束时、治疗结束3个月时的膀胱颈移动度短于治疗前,膀胱后角小于治疗前(P<0.05);ESBT联合康复手法组、ESBT组、电针组治疗结束3个月时的膀胱颈移动度短于治疗结束时,膀胱后角小于治疗结束时(P <0.05);ESBT联合电针组治疗结束3个月时的膀胱颈移动度和膀胱后角与治疗结束时比较,差异无统计学意义(P> 0.05)。ESBT联合电针组、ESBT联合康复手法组治疗结束时、治疗结束3个月时的膀胱颈移动度短于ESBT组、电针组,膀胱后角小于ESBT组、电针组(P <0.05)。四组治疗结束时和治疗结束3个月时的Ⅰ类肌纤维60 s耐力收缩平均肌电值和Ⅱ类肌纤维快速收缩最大肌电值大于治疗前(P<0.05)。ESBT联合康复手法组、ESBT组、电针组治疗结束3个月时Ⅰ类肌纤维60 s耐力收缩平均肌电值和Ⅱ类肌纤维快速收缩最大肌电值均小于治疗结束时(P <0.05),ESBT联合电针组治疗结束3个月时的Ⅰ类肌纤维60 s耐力收缩平均肌电值和Ⅱ类肌纤维快速收缩最大肌电值与治疗结束时比较,差异无统计学意义(P> 0.05)。ESBT联合电针组、ESBT联合康复手法组治疗治疗结束时、治疗结束3个月Ⅰ类肌纤维60 s耐力收缩平均肌电值和Ⅱ类肌纤维快速收缩最大肌电值均大于ESBT组、电针组(P<0.05)。结论 ESBT联合电针治疗产后膀胱膨出,在疗效持久性上效果显著,能更稳定地恢复膀胱结构和盆底肌功能,可作为产后膀胱膨出康复治疗的首选方法。Objective To observe the clinical effect of different rehabilitation methods in the treatment of postpartum cystocele.Methods A total of 160 patients with postpartum cystocele who were treated in Jiangbin Hospital of Guangxi Zhuang Autonomous Region from July 2021 to July 2023 were selected as the research objects.According to different rehabilitation treatment methods,they were divided into the electric stimulation biofeedback therapy(ESBT) group,ESBT combined with rehabilitation manipulation group,ESBT combined with electroacupuncture group and electroacupuncture group,with 40 cases in each group.The bladder neck mobility,posterior bladder angle and pelvic floor muscle function were compared among the four groups.Results At the end of treatment and 3 months after treatment,the bladder neck mobility of the four groups was shorter than that before treatment,and the posterior bladder angle was smaller than that before treatment(P < 0.05).At 3 months after treatment,the bladder neck mobility in the ESBT combined rehabilitation manipulation group,the ESBT group and the electroacupuncture group was shorter than that at the end of treatment,and the posterior bladder angle was smaller than that at the end of treatment(P < 0.05).There was no significant difference in bladder neck mobility and posterior bladder angle between the ESBT combined with electroacupuncture group at 3 months after treatment and the end of treatment(P > 0.05).At the end of treatment and 3 months after treatment,the bladder neck mobility in the ESBT combined with electroacupuncture group and the ESBT combined rehabilitation manipulation group was shorter than that in the ESBT group and the electroacupuncture group,and the posterior bladder angle was smaller than that in the ESBT group and the electroacupuncture group(P < 0.05).The average electromyography value of 60 s endurance contraction of type Ⅰ muscle fiber and the maximum electromyography value of rapid contraction of type Ⅱ muscle fiber at the end of treatment and 3 months after treatm

关 键 词：电刺激生物反馈疗法联合电针 康复手法 产后 膀胱膨出 

分 类 号：R714[医药卫生—妇产科学]