基于盆底表面肌电和超声评估的磁电联合治疗对产后盆底功能障碍的疗效观察

关键词：产后盆底功能障碍  生物反馈电刺激治疗  功能性磁刺激  经会阴四维超声  联合治疗

Keywords:postpartum pelvic floor dysfunction  biofeedback electrical stimulation therapy  functional magnetic stimulation  transperineal four-dimensional ultrasound  combined treatment

摘要：

      摘要 目的：评估盆底康复磁电联合治疗方法对女性产后盆底功能障碍（PFD）的临床疗效。 方法：60例PFD患者被随机分为电刺激组、磁刺激组和联合组，每组20例。评价指标为盆底表面肌电Glazer评估、盆底四维超声、MOS评级、PFDI-20、PISQ-12量表评分，所有指标均在基线和治疗6周后评估。 结果：治疗6周后，3组患者的盆底表面肌电Glazer评估、MOS评级、PISQ-12、 PFDI-20评分及盆底四维超声指标均较治疗前改善（P＜0.05）。与电刺激组相比，联合组对于盆底表面肌电Glazer评估（除快速收缩最大值P＞0.05）、PFDI-20评分和盆底四维超声（除肛提肌裂孔面积P＞0.05）改善更优（P＜0.05）。与磁刺激组相比，联合组对于盆底表面肌电Glazer评估、MOS评级、PISQ-12评分、PFDI-20评分、膀胱颈移动度和肛提肌裂孔面积改善更优（P＜0.05）。电刺激组与磁刺激组相比，差异均无显著性意义（P＞0.05）。 结论：磁电联合治疗可以显著改善产后盆底功能障碍患者盆底结构和功能，提高生活质量。

Abstract:

      Abstract Objective： To evaluate the clinical effects of a combined pelvic floor rehabilitation magneto-electric therapy approach in women with postpartum pelvic floor dysfunction （PFD）. Method： Sixty patients with PFD were randomly divided into three groups: an electrical stimulation group， a magnetic stimulation group， and a combined group, with 20 patients in each group. The evaluation indexes were pelvic floor surface electromyography (sEMG) Glazer assessment， four-dimensional ultrasound of the pelvic floor， MOS rating， PFDI-20， and PISQ-12 scores. All indexes were evaluated at baseline and after 6 weeks of treatment. Result： After 6 weeks of treatment， the pelvic floor sEMG Glazer assessment， MOS ratings， PISQ-12， PFDI-20 scores， and pelvic floor four-dimensional ultrasound indexes of the patients in all three groups were improved compared with those of the pre-treatment period （P<0.05）. Compared with the electrical stimulation group， the combined group showed superior improvement for pelvic floor sEMG Glazer assessment （except for rapid contraction maxima）， PFDI-20 scores， and pelvic floor four-dimensional ultrasound （except for area of levator hiatus）（P<0.05）. Compared to the magnetic stimulation group, the combined group showed superior improvement in pelvic floor sEMG Glazer assessment， MOS ratings， PISQ-12 scores， PFDI-20 scores， bladder neck mobility， and area of levator hiatus（P<0.05）. None of the differences were statistically significant in the electrical stimulation group compared to the magnetic stimulation group （P>0.05）. Conclusion： Magneto-electricity therapy can significantly improve the pelvic floor structure and function of patients with postpartum pelvic floor dysfunction and improve the quality of life， making it worthy of clinical promotion.