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中华临床医师杂志(电子版) ›› 2021, Vol. 15 ›› Issue (09) : 646 -651. doi: 10.3877/cma.j.issn.1674-0785.2021.09.002

临床研究

磁电联合综合盆底康复治疗对盆底松弛患者的疗效观察
张冉1,(), 张明2, 刘风平1, 郭京丽1   
  1. 1. 100074 北京,中国航天科工集团七三一医院门诊部
    2. 100730 北京,北京医院(门诊部)国家老年医学中心 中国医学科学院老年医学研究所
  • 收稿日期:2021-06-16 出版日期:2021-09-15
  • 通信作者: 张冉
  • 基金资助:
    中国航天科工集团公司2020年医疗卫生科研项目(2020-LCYL-020)

Efficacy of combined treatment with magnetic and electrical stimulation as a comprehensive rehabilitation therapy for patients with pelvic floor relaxation

Ran Zhang1,(), Ming Zhang2, Fengping Liu1, Jingli Guo1   

  1. 1. Outpatient Department, China Aerospace Science & Industry Corporation 731 Hospital, Beijing 100074, China
    2. Outpatient Department, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2021-06-16 Published:2021-09-15
  • Corresponding author: Ran Zhang
引用本文:

张冉, 张明, 刘风平, 郭京丽. 磁电联合综合盆底康复治疗对盆底松弛患者的疗效观察[J]. 中华临床医师杂志(电子版), 2021, 15(09): 646-651.

Ran Zhang, Ming Zhang, Fengping Liu, Jingli Guo. Efficacy of combined treatment with magnetic and electrical stimulation as a comprehensive rehabilitation therapy for patients with pelvic floor relaxation[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(09): 646-651.

目的

探讨磁电联合综合盆底康复治疗对盆底松弛患者的临床疗效。

方法

选择2019年8月1日至2021年4月30日在中国航天科工集团七三一医院妇产科门诊诊断为盆底松弛的292例患者为研究对象,以挂号序号随机分为观察组147例(磁电联合组)和对照组145例(电刺激组),2组患者均进行家庭训练,治疗前后行Glazer评估,前瞻性研究盆底表面肌电值以及盆底肌力变化情况,评估2组治疗的临床效果。

结果

(1)盆底表面肌电值:与治疗前比较,2组治疗后前静息平均值、紧张收缩平均值、耐力收缩平均值方面均明显改善(P均<0.05),观察组患者治疗后快速收缩最大值提高,差异有统计学意义(P<0.05),对照组治疗前后快速收缩最大值差异无统计学意义(P>0.05);观察组治疗后快速收缩最大值变化幅度大于对照组,差异有统计学意义(P<0.05),2组间前静息平均值、紧张收缩平均值、耐力收缩平均值、后静息平均值变化差异无统计学意义(P均>0.05)。(2)临床疗效比较:观察组治疗后盆底肌力总有效率为76.87%,其中显效占比39.82%;对照组治疗后盆底肌力总有效率为73.10%,其中显效占比20.75%;2组比较,治疗总有效率差异无统计学意义(P>0.05),但显效占比差异有统计学意义(P<0.05)。

结论

磁电联合综合治疗和电刺激治疗均可改善盆底松弛患者的盆底肌力,磁电联合综合治疗对快肌纤维快速收缩力的提升优于单纯电刺激治疗,且显效率更高,值得推广。

Objective

To evaluate the clinical efficacy of combined treatment with magnetic and electrical stimulation as a comprehensive rehabilitation therapy for patients with pelvic floor relaxation.

Methods

A total of 292 patients diagnosed with pelvic floor relaxation at the Department of Obstetrics and Gynecology of China Aerospace Science and Industry Corporation 731 Hospital from August 1, 2019 to April 30, 2021 were included in this study. Among these patients, 147 were randomly selected into an observation group (combined treatment with magnetic and electrical stimulation), and the other 145 cases were assigned to a control group (electrical stimulation treatment) according to the registered number. Both groups of patients conducted home training and received Glazer assessment before and after treatment to observe changes in the surface electromyography (sEMG) of the pelvic floor muscles (PFMs) in order to evaluate the clinical efficacy.

Results

Compared with the values before treatment, the sEMS measurements were improved in both groups after treatment in terms of the pre-resting average value, the tension contraction average value, and the endurance contraction average value (P<0.05 each). For the observation group, the maximum value of fast muscle contraction significantly increased after treatment (P<0.05), while the control group had no statistical change (P>0.05). After treatment, the rangeability of the maximum value of fast muscle contraction in the observation group was significantly larger than that of the control group (P<0.05), while there was no significant difference in the pre-resting average value, tension contraction average value, endurance contraction average value, and post-resting average value between the two groups after treatment (P>0.05 each). The total effective rate of improving pelvic floor muscle strength after treatment in the observation group was 76.87%, with 39.82% showing marked improvement. The total effective rate of improving pelvic floor muscle strength after treatment in the control group was 73.10%, with 20.75% showing marked improvement. There was no statistically significant difference in the total effective rate of treatment between the two groups (P>0.05), but the difference in the rate of marked improvement was statistically significant (P<0.05).

Conclusion

Combined treatment with magnetic and electrical stimulation and pure electrostimulation treatment both can improve the pelvic floor muscle function of patients with pelvic floor relaxation. Combined treatment has better results in improving the fast muscle contraction, is a more effective therapy, and it is worthy of promotion.

表1 2组盆底松弛患者一般资料比较
表2 2组盆底松弛患者治疗前后盆底表面肌电值的组内比较(
xˉ
±s)
表3 2组盆底松弛患者治疗前后盆底表面肌电值变化的组间比较(
xˉ
±s)
4
叶茜, 钮琳玮, 赵玲. 产妇盆底功能情况调查及产科因素对盆底功能的近期影响分析研究 [J]. 实用妇产科杂志, 2016, 32(11): 843-846.
5
叶仁静, 俞红丽. 盆底肌康复锻炼辅助生物反馈电刺激改善产后盆底肌功能的研究 [J].医药论坛杂志, 2018, 39(7): 52-54.
6
尹玲, 曾碧涛, 朱咏梅. 不同盆底康复治疗女性产后盆底功能障碍疗效评估 [J]. 中国性科学, 2015, 24(11): 106-108.
7
边仁秀, 吴方超, 何晴, 等. 长期卧床脑卒中患者盆底表面肌电变化及特征分析 [J]. 中华物理医学与康复杂志, 2020, 42(9): 805-807.
8
曹燕, 傅琦博, 司俊文, 等. 非侵入式盆底肌康复疗法对产后盆底功能恢复的影响 [J]. 上海护理, 2019, 19(7): 31-33.
9
吕小娟, 唐佳松, 张琳, 等. 盆底磁刺激治疗产后盆腔器官脱垂的疗效观察 [J]. 中国妇幼保健, 2019, 34(23): 5532-5534.
10
李慧. 阴道分娩产妇不同时间行盆底康复训练的护理效果观察 [J]. 中外女性健康研究, 2020(22): 150-151.
11
卓晓云. 生物反馈联合电刺激治疗在产后盆底康复中的临床效果 [J]. 现代诊断与治疗, 2014, 25(19): 4512-4513.
12
吴小文, 陈巧玲, 何爽爽. 早期盆底康复锻炼对不同分娩方式产后压力性尿失禁的影响 [J]. 中国妇幼保健, 2021, 36(1): 13-15.
13
赵梅, 李珊, 项丽, 等. 生物反馈联合电刺激对产后妇女盆底功能及血清松弛素水平影响 [J]. 青岛大学学报(医学版), 2019, 55(3): 279-283.
14
邹凡, 蔺俊斌, 李颖, 等. 盆底磁刺激治疗女性尿失禁的系统评价与meta分析 [J]. 中国康复医学杂志, 2019, 34(8): 966-970.
15
胡月, 甄长青, 李连军. 电磁刺激疗法在治疗女性尿失禁中的疗效 [J/OL]. 泌尿外科杂志(电子版), 2015, 7(2): 60-63.
16
王阳贇, 焦伟, 史朝亮, 等. 盆底磁刺激联合生物反馈治疗女性膀胱过度活动症的疗效观察 [J]. 现代泌尿外科杂志, 2019, 24(2): 98-101.
17
Lim Renly,Men Long Liong, et al. Effect of pulsed magnetic stimulation on sexual function in couples with female stress urinary incontinence partners [J]. J Sex Marital Ther, 2018, 44(3): 260-268.
18
Lim R, Liong ML, Leong WS, et al. Pulsed magnetic stimulation for stress urinary incontinence: 1-year followup results [J]. J Urol, 2017, 197(5): 1302-1308.
1
胡青, 李文娟, 张祖娟, 等. 不同电刺激方案对弱肌力相关女性松弛型盆底功能障碍的短期疗效研究 [J]. 中国康复医学杂志, 2020, 35(9): 1117-1120.
2
Oversand SH, Atan IK, Shek KL, et al. The association between different measures of pelvic floor muscle function and female pelvic organ prolapse [J]. Int Urogynecol J, 2015, 26(12): 1777-178.
3
中华医学会妇产科学分会妇科盆底学组. 女性压力性尿失禁诊断和治疗指南(2017) [J].中华妇产科杂志, 2017, 52(5): 289-293.
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