摘要
目的:评价盆底肌肉锻炼法联合直接阴道低压低频电刺激(DES)对初产妇女分娩后盆腔神经电生理和组织功能的影响。方法:选取2016年1月至2017年12月重庆市丰都县人民医院收治的足月初产妇女105例,按随机数表法分为三组,对照组(n=31)产后2小时接受常规产后指导,锻炼组(n=33)进行产后2天至产后3个月的盆底肌肉锻炼,联合组(n=34)同锻炼组,并从产后第6周开始DES 15次(每周3次,每次30分钟~35分钟)。采用国际标准评分法对产妇的盆腔器官脱垂情况、尿失禁评分和盆底肌肉强度等进行评分,数据在进行试验的第3个月随访收集。结果:产后3个月,三组产妇的POP-Q分级、尿失禁分数、盆底肌力评分和盆底肌电生理情况组间差异均具有统计学意义(P <0. 05),且耻骨联合清除方面存在显着差异,提示锻炼法可以促进母体耻骨联合的康复和骨盆的恢复。联合用药组治疗后总电值、Ⅰ型肌纤维强度和Ⅱ型肌纤维强度均显着高于治疗前。结论:康复训练联合DES治疗有利于产后盆腔神经组织功能的恢复,两种方法联合应用均有协同作用,可以更好地缓解产后不适症状,提高女性生活质量。
Objective:To evaluate the effects of pelvic floor muscle exercise combined with direct vaginal low pressure electrical stimulation (DES) on electrophysiology and tissue function of pelvic nerves after delivery in primiparous women. Methods: 105 full-term primiparous women in Chongqing Fengdu County People's Hospital from January 2016 to December 2017 were divided into three groups according to the random number table. The control group ( n = 31 ) received routine postnatal instruction at 2 hours postpartum. The training group ( n = 33) performed pelvic floor muscle exercises from 2 day-s postpartum to 3 months postpartum. The combined group ( n = 34) was given the same exercise program and DES 15 times (6 times a week for 30-35 minutes per week). The pel- vic organ prolapses, urinary incontinence score, pelvic floor muscle strength and other maternal life-long treatment were examined using international standard scales and scoring methods. Data were collected at the third month after delivery. Results: There were statistically significant differences among the three groups in POP-Q classification, u- rinary incontinence score, pelvic floor muscle strength and pelvic floor muscle electrophysiology at 3 months postpartum ( P 〈 0. 05 ) , and there was significant difference in pubic symphysis clearance, which indicated that exercise could promote maternal pubic symphysis rehabilitation and pelvic recovery. After treatment, the total electrical value, type I muscle fiber strength and type II muscle fiber strength in the combination group were significantly higher than those before treatment. Conclusions : Rehabilitation training combined with DES is beneficial to the recovery of postoperative pelvic nerve tissue function, which can relieve postpartum discomfort symptoms and improve the quality of sexual life of women.
作者
敖苏
杨霞
张志容
AO Su;YANG Xia;ZHANG Zhirong(Department of Obstetrics and Gynecology,Chongqing Fengdu County People's Hospital,Chongqing 408200,China)
出处
《中国性科学》
2018年第8期103-106,共4页
Chinese Journal of Human Sexuality
关键词
盆底肌肉锻炼法
直接阴道低压低频电刺激
产后盆底功能康复
Pelvic floor exercise method
Direct vaginal low-frequency electrical stimulation
Postpartum pelvic floor functional rehabilitation