[1]陈娟,任远,康佳,等.经阴道植入聚丙烯网片术后盆底肌表面肌电的研究——附36例病例分析[J].中国计划生育和妇产科,2019,(9):23-26,30.
 CHEN Juan,REN Yuan,KANG Jia,et al.Surface electromyography of pelvic floor muscle after transvaginal mesh implantation:Analysis of 36 cases[J].Chinese Journal of Family Planning & Gynecotokology,2019,(9):23-26,30.
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经阴道植入聚丙烯网片术后盆底肌表面肌电的研究——附36例病例分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2019年9期
页码:
23-26,30
栏目:
论著与临床
出版日期:
2019-09-25

文章信息/Info

Title:
Surface electromyography of pelvic floor muscle after transvaginal mesh implantation:Analysis of 36 cases
作者:
陈娟任远康佳张也庞红霞史欣文朱兰*
中国医学科学院 北京协和医院普通妇科中心
Author(s):
CHEN Juan REN Yuan KANG Jia ZHANG Ye PANG Hong-xia SHI Xin-wen ZHU Lan*
Department of General Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R.China
关键词:
子宫脱垂盆底肌肉妇科外科手术表面肌电前瞻性研究
Keywords:
uterine prolapse pelvic floor muscle gynecologic surgical procedures surface electromyography prospective study
分类号:
R 71123
摘要:
目的探讨盆腔器官脱垂(pelvic organ prolapse, POP)患者经阴道植入网片全盆底重建术后盆底肌表面肌电的变化。方法选取北京协和医院2016年7月至2017年12月间36例POP重度患者,所有患者行经阴道植入网片全盆底重建手术,其中2例合并压力性尿失禁者同时行尿道中段悬吊术(TVT)。记录患者手术前和术后3个月Glazer盆底肌表面肌电评估结果;POP-Q评分评价手术解剖学疗效;盆底功能影响问卷简表(PFIQ-7)和盆底不适调查表简表(PFDI-20)评估生活质量。结果手术治疗前后,快速收缩最大波幅分别为(3719±2540)μV和(3424±1624)μV;持续收缩的平均波幅分别为1790(1446,2530)μV和2066(1585,2686)μV;耐久收缩的平均波幅分别为(2133±1487)μV和(2129±952)μV,以上各项差异均无统计学意义(P>005)。后静息电位基线值术后(622±290)μV较术前(484±210)μV明显升高,快速收缩的放松时间术后107(033,900)s较术前041(019,120)s延长,差异有统计学意义(P<005)。术后3个月随访时,POP-Q评分Aa、Ba、C、Ap和Bp各点均较术前有明显上升,PFIQ-7 和PFDI-20的术后评分较术前降低,差异有统计学意义(P<005)。有1例患者术后3个月复发,但不需要再次手术治疗;有1例新发尿失禁患者,没有网片相关的疼痛和暴露并发症。结论经阴道植入网片术后,盆底肌收缩波幅较前无明显变化,但是出现了高张型盆底功能障碍的肌电信号特点。
Abstract:
ObjectiveTo investigate the changes of surface electromyography in pelvic floor muscles after transvaginal mesh procedure in pelvic organ prolapse (POP) patients. MethodsFrom July 2016 to December 2017, 36 patients with POP stage Ⅲ~Ⅳ in Peking Union Med

参考文献/References:

[1]MAHER C,FEINER B,BAESSLER K,et al. Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse [J]. Cochrane Database Syst Rev,2016, 2:CD012079. [2]Gyang AN, Feranec JB, Patel RC. Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh[J]. Int Urogynecol J, 2014, 25(3): 313-318. [3]朱兰,郎景和,任常,等.改良全盆底重建术 [J].中华妇产科杂志,2007,42(9):634-635. [4]ZHU Lan, YU Si-jun, XU Tao, et al. Chinese validation of the Pelvic Floor Impact Questionnaire Short Form [J]. Menopause-The Journal of The North American Menopause Society, 2011, 18(9): 1030-1033. [5]MA Yi-di, XU Tao, ZHANG Ye, et al. Validation of the Chinese version of the Pelvic Floor Distress Inventory-20 (PFDI-20) according to the COSMIN checklist [J]. Int Urogynecol J, 2019, 30(7): 1127-1139. [6]丁曙晴.表面肌电介导盆底生物反馈的发展[J].临床外科杂志,2009,17(4):224-225. [7]Messelink B, Benson T, Berghmans B, et al. Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society[J]. Neurourol Urodyn, 2005, 24(4): 374-380. [8]Braekken IH, Majida M, Engh ME, et al. Pelvic floor function is independently associated with pelvic organ prolapse[J]. BJOG, 2009, 116(13): 1706-1714. [9]Handa VL, Roem J, Blomquist JL, et al. Pelvic organ prolapse as a function of levator ani avulsion, hiatus size, and strength [J]. Am J Obstet Gynecol, 2019, 222(1): 4. [10]Delancey JO, Morgan DM, Fenner DE, et al. Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse[J]. Obstet Gynecol, 2007, 109(2, 1): 295-302. [11]Hagen S, Glazener C, Mcclurg D, et al. Pelvic floor muscle training for secondary prevention of pelvic organ prolapse (PREVPROL): a multicentre randomised controlled trial[J]. Lancet, 2017, 389(167): 393-402. [12]Hagen S SD, Poppy TC. Individualised pelvic floor muscle training in women with pelvic organ prolapse(POPPY):a multicentre randomised controlled trial [J]. Lancet, 2014, 383(9919): 796-806. [13]Schachar JS, Devakumar H, Martin L, et al. Pelvic floor muscle weakness: a risk factor for anterior vaginal wall prolapse recurrence[J]. Int Urogynecol J, 2018, 29(11): 1661-1667. [14]WANG Li-hua, CHEN Xin-liang, LI Xiao-cui, et al. The improvement of pelvic floor muscle function in POP patients after the Prolift procedure: results from surface electromyography[J]. Int Urogynecol J, 2013, 24(10): 1703-1708. [15]张晓红,梁莉明,苗娅莉,等.盆底重建手术前后患者生活质量及盆底肌肌电变化初步探讨 [J].中国妇产科临床杂志,2010,11(1):12-14. [16]吴宏.盆底重建联合悬吊术对盆底功能障碍性疾病患者盆底肌肌电以及生活质量的影响[J].中国医药导报,2016,13(29):71-74. [17]Pereira LC, Botelho S, Marques JA, et al. Electromyographic pelvic floor activity: Is there impact during the female life cycle?[J]. Neurourol Urodyn, 2016, 35(2): 230-234. [18]李凡,周萍.盆底重建术后肌电生物反馈治疗的疗效分析[J].生殖医学杂志,2012,21(4):346-349. [19]Gyang A, Hartman M, Lamvu G. Musculoskeletal causes of chronic pelvic pain what a gynecologist should know[J]. Obstet Gynecol, 2013, 121(3): 645-650. [20]Aungst MJ, Friedman EB, Von Pechmann WS, et al. De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair [J]. Am J Obstet Gynecol, 2009, 201(1): e1-e7. [21]Butrick CW. Pelvic floor hypertonic disorders: identification and management[J]. Obstet Gynecol Clin North Am, 2009, 36(3): 707. [22]Halski T, Ptaszkowski K, Slupska L, et al. Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women:a prospective observational study[J]. Clin Interv Aging, 2017, 4(12): 75-83.

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备注/Memo

备注/Memo:
国家自然科学基金重点项目(项目编号:81830043);中国医学科学院创新工程项目 (项目编号:CAMS-2017-12M-1-002)
更新日期/Last Update: 2019-09-25