生物反馈电刺激联合阴式子宫切除术在老年盆腔器官脱垂中的应用效果  

Application effect of biofeedback electrical stimulation combined with vaginal hysterectomy in elderly patients with pelvic organ prolapse

作　　者：马文巧 王海波 李萍 胡晓丽 杜春园 宁艳芳 李荣贤 甄银芝 Ma Wenqiao;Wang Haibo;Li Ping;Hu Xiaoli;Du Chunyuan;Ning Yanfang Li Rongxian;Zhen Yinzhi(Department of Obstetrics and Gynecology,Noncommissioned Officer School Hospital,Army Medical University,Shijiazhuang 050000,China;Department of Psychology,Zhengding 256 Hospital,Shijiazhuang 050000,China)

机构地区：[1]陆军军医大学士官学校附属医院妇产科,石家庄050000 [2]正定二五六医院心理科,石家庄050000

出　　处：《中华内分泌外科杂志（中英文）》2024年第6期903-908,共6页Chinese Journal of Endocrine Surgery

基　　金：2023年度河北医学科学研究课题计划(20231720)。

摘　　要：目的探讨生物反馈电刺激(BF-FES)联合阴式子宫切除术(TVH)在老年盆腔器官脱垂(POP)患者中的应用效果。方法选取2020年7月至2022年12月陆军军医大学士官学校附属医院收治的92例老年POP患者作为研究对象,依据随机数字表法分为观察组(45例)与对照组(47例)。对照组实施TVH治疗,术后常规进行盆底康复训练;观察组在对照组基础上实施BF-FES治疗,均连续治疗4周并随访6个月。比较两组治疗前、治疗4周表面肌电值、三维盆底超声参数及尿动力学指标,比较治疗前、治疗4周及随访3个月、6个月的1h尿垫试验结果。结果两组患者治疗4周各阶段表面肌电值高于治疗前。观察组前静息、快速收缩、紧张收缩、耐力收缩及后静息阶段表面肌电值均高于对照组(P<0.05)。两组治疗4周膀胱颈移动度高于治疗前,尿道膀胱后角、尿道旋转角度低于治疗前。观察组膀胱颈移动度高于对照组,尿道膀胱后角、尿道旋转角度低于对照组(P<0.05)。两组治疗4周最大尿流率、最大膀胱容量、平均尿流率高于治疗前,残余尿量低于治疗前;观察组最大尿流率、最大膀胱容量、平均尿流率高于对照组;观察组残余尿量低于对照组(P<0.05)。治疗4周、随访3个月、随访6个月两组患者1 h尿垫重量增加量与治疗前比较逐渐降低,且观察组治疗后低于对照组(P<0.05)。结论BF-FES联合TVH能显著增强老年POP患者盆腔肌力,改善盆底超声参数及尿动力学指标,对患者尿失禁的治疗效果显著。ObjectiveTo explore the application effect of biofeedback functional electrical stimulation(BF-FES)combined with vaginal hysterectomy(TVH)in elderly patients with pelvic organ prolapse(POP).MethodsA prospective study was conducted on 92 elderly POP patients admitted to the hospital from Jul.2020 to Dec.2022.They were divided into a study group(45 cases)and a control group(47 cases)using a random number table method.The control group received TVH treatment and underwent routine pelvic floor rehabilitation training after surgery;The research group received BF-FES treatment on the basis of the control group.All patients were treated continuously for 4 weeks and followed up for 6 months.The surface electromyographic values,three-dimensional pelvic floor ultrasound parameters,and urodynamic indicators between the two groups were compared before treatment and at 4 weeks of treatment.The results of the 1-hour urinary pad test before treatment,at 4 weeks of treatment,and at 3 and 6 months of follow-up were compared.ResultsThe surface electromyographic values of the two groups of patients at each stage of treatment for 4 weeks were higher than those before treatment.The surface electromyographic values of the study group at rest,rapid contraction,tense contraction,endurance contraction,and post rest stages were higher than those of the control group(P<0.05).After 4 weeks of treatment,the mobility of the bladder neck in both groups was higher than those before treatment,while the posterior angle and rotation angle of the urethra and bladder were lower than those before treatment;The mobility of the bladder neck in the study group was higher than that in the control group,while the posterior angle of the urethra and bladder,as well as the rotation angle of the urethra were lower than those of the control group(P<0.05).The maximum urine flow rate,maximum bladder volume,and average urine flow rate of the two groups after 4 weeks of treatment were higher than those before treatment,while residual urine volume was lower than th

关 键 词：盆腔器官脱垂 老年 生物反馈电刺激 阴式子宫切除术 尿失禁 

分 类 号：R713.42[医药卫生—妇产科学]