[1]闫梅*,温琦,梁开如,等.不同时机盆底康复治疗产后盆底功能障碍性 疾病的近期疗效[J].中国计划生育和妇产科,2019,(5):51-55.
　YAN Mei*,WEN Qi,LIANG Kai-ru,et al.Short-term effects of pelvic floor rehabilitation at different timings on postpartum pelvic floor dysfunction[J].Chinese Journal of Family Planning & Gynecotokology,2019,(5):51-55.
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不同时机盆底康复治疗产后盆底功能障碍性 疾病的近期疗效
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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5期
页码:
51-55
栏目:
论著与临床
出版日期:
2019-05-25

文章信息/Info

Title:
Short-term effects of pelvic floor rehabilitation at different timings on postpartum pelvic floor dysfunction
作者:
闫梅*; 温琦; 梁开如; 张琳琳; 李玉梅; 卢旦缘; 罗刘衡
四川省妇幼保健院·四川省妇女儿童医院妇女保健科
Author(s):
YAN Mei*; WEN Qi; LIANG Kai-ru; ZHANG Lin-lin; LI Yu-mei; LU Dan-yuan; LUO Liu-heng
Department of Women Health, Sichuan Provincial Hospital for Women and Children， Chengdu Sichuan 610031,P.R.China
关键词:
不同时机; 盆底肌力; SUI;  脏器脱垂
Keywords:
different periods; pelvic floor muscle strength; stress urinary incontinence; pelvic organ prolapsed
分类号:
R 71123
摘要:
目的 观察产后42 d诊断盆底功能障碍的产妇，在不同时间段采用生物反馈联合电刺激的治疗效果。方法选取2014年6月至2017年1月在四川省妇幼保健院就诊，产后42 d复查诊断盆底功能障碍后进行盆底治疗1疗程的产妇378例，根据产后不同治疗时间段分组，A 组(314例)，产后42 d～3月；B组(50例)，产后3～6月；C组(14例)，产后6月～2年，比较盆底治疗前后产妇盆底肌力、压力性尿失禁（stress urinary incontinence，SUI）及脏器脱垂情况。结果A 组在盆底治疗前后，盆底电测肌电值、Ⅰ类、Ⅱ类肌力较训练前增强，SUI发生率、阴道前壁脱垂率、子宫脱垂率、阴道后壁脱垂率较之前均明显降低，差异有统计学意义(P<005)。B 组的盆底电测肌电值、Ⅰ类、Ⅱ类肌力较训练前增强，SUI 发生率较之前均明显降低，差异有统计学意义(P<005)；阴道前壁脱垂率、子宫脱垂率、阴道后壁脱垂率与治疗前相比，差异无统计学意义（P>005）。C 组的盆底电测肌电值、Ⅰ类、Ⅱ类肌力较训练前增强、SUI发生率较之前降低，差异无统计学意义（P>005）。结论产后盆底康复治疗在产后42 d～3月内，疗效显著。产后3～6月和产后6月～2年因脏器脱垂进行治疗的人群，需要增加疗程进一步观察治疗效果。
Abstract:
ObjectiveTo observe the short-term effect of electric stimulation-biofeedback pelvic floor rehabilitation therapy at different postpartum periods for pelvic floor dysfunction(PFD) women in 6 weeks postpartum. Methods378 cases of PFD diagnosed at 42 days postpartum visit in Sichuan Provincial Hospital for Women and Children were selected to undergo therapy of biofeedback combined with electrical stimulation，according to treatment at different postpartum periods, the patients were divided into three groups：Group A(n=314)(treated at postpartum day 42～month 3)，Group B(n=50)(treated at postpartum month 3～6)，and Group C(n=14)(treated at postpartum month 6～year 2)．The changes of pelvic floor muscle strength, stress urinary incontinence and pelvic organ prolapsed before and after treatment in different postpartum periods were compared. ResultsIn group A，the voltage of total pelvic floor muscle, the voltage of muscle fiber I and fiber II increased significantly after therapy of biofeedback combined with electrical stimulation(P<005). The incidence of stress urinary incontinence and pelvic organ prolapsed decreased significantly after therapy(P<005). In group B，the voltage of total pelvic floor muscle, the voltage of muscle fiber I and fiber II increased significantly after therapy of biofeedback combined with electrical stimulation(P<005). The incidence of stress urinary incontinence and decreased significantly after therapy (P<005). In group C, there was no significant difference between the front and the back.ConclusionElectric stimulation-biofeedback pelvic floor rehabilitation in treatment of PFD may have obvious short-term effect for the women treated at postpartum day 42～month 3．More therapy procedures should be needed in women with pelvic organ prolapsed treated at postpartum month 3~6 and women treated at postpartum month 6～year 2.

参考文献/References:

［1］孙智晶，朱兰，郎景和，等. 盆底肌肉训练在盆底功能障碍性疾病防治中的作用 ［J］. 中华妇产科杂志，2017，52 (2):138-140. ［2］ARNOUK A，DE E-lise，REHFUSS A，et al. Physical，complementary，and alternative medicine in the treatment of pelvic floor disorders ［J］. Current Urology Reports，2017，18 (6):47. ［3］STRINIC T，BUKOVIC D，ROJE D，et al. Epidemiology of pelvic floor disorders between urban and rural female inhabitants ［J］. Collegium Antropologicum，2007，31 (2): 483-487. ［4］蒋红，吴艳．产后盆底肌电刺激对不同分娩方式盆底肌力近期疗效观察 ［J］．实用妇产科杂志，2012，28 （2）：145-147． ［5］CAROCI A D，RIESCO M L，SOUSA W D，et al. Analysis of pelvic floor musculature function during pregnancy and postpartum: a cohort study: (a prospective cohort study to assess the PFMS by perineometry and digital vaginal palpation during pregnancy and following vaginal or caesarean childbirth)［J］. Journal of Clinical Nursing，2010，19 (17/18): 2424-2433. ［6］闫梅，王晓银，温琦，等．不同产科因素对产后妇女盆底功能障碍的影响 ［J］．中国计划生育和妇产科，2015，7 （8）：36-41． ［7］祁锋，李环，张巍颖，等．产后盆底康复治疗最佳时机研究现状 ［J］．罕少疾病杂志，2011，18 （2）：46-49． ［8］KOH C E，YOUNG C J，YOUNG J M，et al. Systematic review of randomized controlled trials of the effectiveness of biofeedback for pelvic floor dysfunction ［J］. The British Journal of Surgery，2008，95 (9): 1079-1087. ［9］闫梅，王晓银，温琦，等．不同分娩方式产后盆底障碍的的盆底康复治疗近期疗效观察［J］．四川医学，2017，38（11）：1295-1300． ［10］SANGSAWANG B. Risk factors for the development of stress urinary incontinence during pregnancy in primigravidae: a review of the literature ［J］. European Journal of Obstetrics & Gynecology and Reproductive Biology，2014，178 (7): 27-34. ［11］孙智晶,朱兰,郎景和,等.初产妇产后6周盆底电生理指标及盆腔器官脱垂分度状况全国多中心横断面研究 ［J］.中国实用妇科与产科杂志,2015,31 (5):433-439. ［12］孙智晶，朱兰，郎景和，等．产后盆底康复锻炼对女性盆底功能障碍性疾病的预防作用 ［J］．中华妇产科杂志，2015，50 （6）：420-427． ［13］Wilson P D，Herbison G P . A randomized controlled trial of pelvic floor muscle exercises to treat postnatal urinary incontinence ［J］. International Urogynecology Journal & Pelvic Floor Dysfunction，1998，9 (5):257-264. ［14］LEE I S，CHOI E S. Pelvic floor muscle exercise by biofeedback and electrical stimulation to reinforce the pelvic floor muscle after normal delivery ［J］. Taehan Kanho Hakhoe chi，2006，36 (8): 1374-1380. ［15］MEYER S，HOHLFELD P，ACHTARI C，et al. Pelvic floor education after vaginal delivery ［J］. Obstetrics and Gynecology，2001，97 (5 Pt 1): 673-677. ［16］HADDOW G，WATTS R，ROBERTSON J. Effectiveness of a pelvic floor muscle exercise program on urinary incontinence following childbirth ［J］. International Journal of Evidence-based Healthcare，2005，3 (5): 1-62. ［17］张斌，王素珍，黄健．生物电刺激治疗不同分娩方式产后盆底肌力减退的比较研究 ［J］．实用妇产科杂志，2012，28（10）：849-852． ［18］Harvey, Marieandrée. Pelvic Floor Exercises During And After Pregnancy: A Systematic Review Of Their Role In Preventing Pelvic Floor Dysfunction ［J］. Journal of Obstetrics & Gynaecology Canada，2003，25(6):487-498. ［19］MEYER S，HOHLFELD P，ACHTARI C，et al. Pelvic floor education after vaginal delivery ［J］. Obstetrics and Gynecology，2001，97 (5 Pt 1): 673-677. ［20］张燕，田丽君．不同时机的个体化产后盆底康复治疗临床应用研究 ［J］．中国医师进修杂志，2014，37 （3）：67-69． ［21］Dumoulin C，Seaborne D E，Quirion-Degirardi C，et al. Pelvic floor rehabilitation，Part 2: Pelvic-floor reeducation with interferential currents and exercise in the treatment of genuine stress incontinence in postpartum women——a cohort study ［J］. Physical Therapy，1995,75(12):1075-1081. ［22］HARVEY M A. Pelvic floor exercises during and after pregnancy: a systematic review of their role in preventing pelvic floor dysfunction ［J］. Journal of Obstetrics and Gynaecology Canada，2003，25 (6): 487-498. ［23］Henry, Woodford，James，George. NICE guidelines on urinary incontinence in women.［J］.Age and ageing,2007,36 (3):349-350. ［24］James P，Neilson.Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.［J］.Obstetrics and Gynecology，2009，113 (3) : 733-735. ［25］Paul, Fine,Kathryn，et al.Teaching and practicing of pelvic floor muscle exercises in primiparous women during pregnancy and the postpartum period［J］.American Journal of Obstetrics and Gynecology,2007,197 (1):107.e1-5.

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更新日期/Last Update: 2019-05-25