河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (9): 1043-1046,1052.doi: 10.3969/j.issn.1007-3205.2023.09.010

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不同时间段生物反馈电刺激结合盆底手法按摩对PFD患者盆底肌力及电生理的影响

  

  1. 江苏省太仓市第一人民医院妇产科，江苏 太仓 215400

  • 出版日期:2023-09-25 发布日期:2023-10-12
  • 作者简介:王芳芳（1983-），女，江苏太仓人，江苏省太仓市第一人民医院副主任医师，医学硕士，从事妇产科疾病诊治研究。
  • 基金资助:
    太仓市科技计划项目（TC2019JCYL09)

Effects of biofeedback electrical stimulation and massage of pelvic floor muscles at different time periods on pelvic floor muscle strength and electrophysiology in patients with pelvic floor dysfunction

  1. Department of Obstetrics and Gynecology, the First People's Hospital of Taicang City, Jiangsu Province,Taicang 215400, China
  • Online:2023-09-25 Published:2023-10-12

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摘要： 目的  探索不同时间段生物反馈结合盆底手法按摩对盆底功能障碍性疾病（pelvic floor dysfunction,PFD）患者盆底肌力和电生理的影响。
方法  选择PFD患者232例为研究对象，按照产后就诊并接受治疗时间段分为A组（产后6周~3个月内接受治疗）135例，B组（产后3~6个月内接受治疗）63例，C组（产后6个月~1年内接受治疗）34例。3组均接受1个疗程生物反馈电刺激及盆底手法按摩的联合治疗后，比较3组盆底肌力改变情况、PFD症状改善情况和电生理情况。
结果  治疗后，A组、B组Ⅰ类纤维肌力、Ⅱ类纤维肌力高于治疗前;且A组、B组盆底肌力高于C组（P＜0.05）。A组、B组压力性尿失禁发生率低于治疗前，A组阴道前壁脱垂、子宫脱垂发生率低于治疗前；A组阴道前壁脱垂发生率低于B组和C组（P＜0.05）。A组、B组Ⅰ类肌纤维疲劳度、Ⅱ类肌纤维疲劳度低于治疗前，阴道动态压力、A3反射正常率高于治疗前；A组和B组Ⅰ类纤维疲劳度、Ⅱ类纤维疲劳度低于C组，A3反射正常率高于C组（P＜0.05）。
结论  PFD患者在产后6周~3个月接受生物反馈电刺激和手法按摩治疗效果最好，病程越长，治疗效果越差，需要后续进一步治疗。


关键词: 盆底功能障碍性疾病, 电刺激疗法, 按摩

Abstract: Objective  To explore the effects of biofeedback combined with massage of pelvic floor muscles at different time periods on pelvic floor muscle strength and electrophysiology in patients with pelvic floor dysfunction(PFD). 
Methods  A total of 232 patients with PFD were selected as the research subjects and divided into group A (receiving treatment within 6 weeks to 3 months after delivery, n=135), group B (receiving treatment within 3 months to 6 months after delivery, n=63), and group C (receiving treatment within 6 months to 1 year after delivery, n=34). After receiving 1 course of combined treatment of biofeedback electrical stimulation and massage of pelvic floor muscles, the change of pelvic floor muscle strength, improvement of symptoms of PFD and electrophysiological status of the three groups were compared. 
Results  After treatment, type Ⅰand type Ⅱ muscle fiber strength in group A and group B were higher than those before treatment, and the pelvic floor muscle strength in group A and group B was higher than that in group C (P＜0.05). The incidence of stress urinary incontinence in group A and group B was lower than that before treatment, and the incidence of anterior vaginal wall prolapse and uterine prolapse in group A was lower than that before treatment. The incidence of anterior vaginal wall prolapse in group A was lower than that in groups B and C (P＜0.05). Type Ⅰ and type Ⅱmuscle fiber fatigue in group A and group B were lower than those before treatment, vaginal dynamic pressure and normal rate of A3 reflex were higher than those before treatment. Type Ⅰ and type Ⅱmuscle fiber fatigue in group A and group B were lower than those in group C, and the normal rate of A3 reflex was higher than that in group C (P＜0.05). 
Conclusion  For patients with PFD, biofeedback electrical stimulation and manual massage at 6 weeks to 3 months after delivery produces the best therapeutic effect. The longer the course of the disease, the worse the therapeutic effect; Therefore, further treatment will be needed. 


Key words: pelvic floor dysfunction, electrical stimulation therapy, massage

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