摘要
目的探讨盆底修复重建手术(Prolift)盆底重建联合电刺激对中重度盆底功能障碍(PFD)的临床疗效及对盆底肌力、肌电及尿流动力学的影响。方法选取2016年1月至2018年12月陕西省汉中市3201医院收治的126例中重度PFD患者作为研究对象。随机数字表法分为观察组(n=63)和对照组(n=63),对照组采取Prolift盆底重建术及常规康复训练治疗,观察组在对照组治基础上采取电刺激治疗。比较两组治疗疗效以及治疗前后盆底功能及盆底肌肌力、肌电值、尿流动力学等指标的变化情况。结果治疗3个月后,观察组客观治愈率显著高于对照组,差异具有统计学意义(P<0.05);观察组ICI-Q-SF、PFIQ7评分显著低于对照组,PISQ-12评分显著高于对照组,差异具有统计学意义(P<0.05)。观察组Ⅰ类肌纤维肌力、Ⅱ类肌纤维肌力中0~Ⅲ级比例、Ⅰ和Ⅱ类纤维疲劳度显著低于对照组,差异具有统计学意义(P<0.05);观察组阴道动态压力显著优于对照组,A3正常比例显著高于对照组,差异具有统计学意义(P<0.05);观察组最大膀胱测定容积、最大尿流率(Q;)均显著高于对照组,残余尿量(PVR)、逼尿肌最大压力(Pdet;)以及Q;对应逼尿肌压力(Pde-tQ;)显著低于对照组,差异具有统计学意义(P<0.001)。结论 Prolift盆底重建术联合电刺激治疗PFD,可明显改善患者症状以及盆底电生理指标和尿流动力学指标。
Objective To investigate the clinical effect of Prolift pelvic floor reconstruction combined with electrical stimulation on pelvic floor dysfunction(PFD) and its effects on pelvic floor muscle strength, electromyography and urodynamics. Methods A total of 126 patients with moderate to severe PFD admitted to 3201 Hospital from January 2016 to December 2018 were selected as the study subjects. Randomized number table method was used to divide the patients into observation group(n=63) and control group(n=63). The control group was treated with Prolift pelvic floor reconstruction and routine rehabilitation training, while the observation group was treated with electrical stimulation in addition to the control group. The therapeutic effect and the changes of pelvic floor function, pelvic floor muscle strength, electromyography and urine flow dynamics before and after treatment were compared between the two groups. Results After 3 months of postoperative treatment, the objective cure rate of the observation group was significantly higher than that of the control group(P<0.05). The scores of ICI-Q-SF, PFIQ7 in the observation group were significantly lower than those in the control group, and the score of PISQ-12 was significantly higher than that in the control group(P<0.05). The muscle strength of class I muscle fiber, the proportion of grade 0~Ⅲ in muscle strength of class Ⅱ muscle fiber, and the fatigue degree of class Ⅰ and Ⅱ fiber in the observation group were significantly lower than those in the control group(P<0.05). The vaginal dynamic pressure in the observation group was significantly better than that in the control group, and the normal proportion of A3 was significantly higher than that in the control group(P<0.05). The maximum measured bladder volume and maximum urine flow rate(Q;) in the observation group were significantly higher than those in the control group, while residual urine volume(PVR), maximum detrusor pressure(Pdet;) and detrusor pressure corresponding to Q;(Pde-tQ;) were significantly lower than those in the control group(P<0.001). Conclusions Prolift pelvic floor reconstruction combined with electrical stimulation in the treatment of PFD can significantly improve the patient′s symptoms, pelvic floor electrophysiological parameters and urodynamics parameters.
作者
周娟
沈兰兰
王君
ZHOU Juan;SHEN Lanlan;WANG Jun(3201 Hospital,Hanzhong 723000,Shaanxi,China)
出处
《中国性科学》
2021年第11期103-107,共5页
Chinese Journal of Human Sexuality
关键词
Prolift盆底重建术
电刺激
盆底功能障碍
盆底肌
收缩力
尿流动力学
Prolift pelvic floor reconstruction
Electrical stimulation
Pelvic floor dysfunction
Pelvic floor muscles
Contractility
Urodynamics
作者简介
通讯作者:周娟,E-mail:c20_c20@126.com。
