神经肌肉电刺激联合Kegel锻炼在产后盆底功能障碍性疾病中的应用

目的 探讨神经肌肉电刺激联合Kegel锻炼在产后盆底功能障碍性疾病(FPFD)中的应用效果。方法 选择2019年1月—2020年12月本院接诊的90例产后FPFD患者,按随机数字表法分为研究组(45例)与对照组(45例)。对照组行单纯Kegel锻炼,在此基础上,研究组行神经肌肉电刺激干预。比较两组康复效果、盆底Ⅰ类和Ⅱ类肌肌力μV、肌纤维收缩时间、最大阴道内压以及压力性尿失禁、性功能障碍发生率。结果 研究组康复总有效率为95.56%,高于对照组的82.22%,差异有统计学意义(χ2=4.050,P=0.044);两组干预3个月后盆底Ⅰ类肌肌力、Ⅱ类肌肌力、肌纤维收缩时间以及最大阴道内压明显高于干预前,差异有统计学意义(P<0.05),研究组盆底Ⅰ类肌肌力为(4.212±0.351)μV、Ⅱ类肌肌力为(4.983±0.508)μV、Ⅰ类肌肌纤维收缩时间为(4.383±0.456)s、Ⅱ类肌肌纤维收缩时间(4.191±0.494)s、最大阴道内压为(83.282±4.157)cmH2O,高于对照组的(2.023±0.315)μV、(2.314±0.451)μV、(3.264±0.418)s、(3.053±0.412)s、(73.355±4.260)cmH2O,有统计学差异(t=31.421、26.626、12.342、11.970、11.201,P均<0.001);研究组干预后压力性尿失禁发生率为4.44%、性功能障碍发生率为35.56%,低于对照组的22.22%、57.78%,差异有统计学意义(χ2=6.154、4.464,P=0.013、0.035)。结论 神经肌肉电刺激联合Kegel锻炼能够有效增强产后FPFD患者盆底肌力,延长肌纤维。

Application of neuromuscular electrical stimulation combined with Kegel exercise in postpartum female pelvic floor dysfunction

Objective To investigate the application effect of neuromuscular electrical stimulation combined with Kegel exercise on postpartum female pelvic floor dysfunction (FPFD). Methods A total of 90 cases of postpartum FPFD in our hospital from January 2019 to December 2020 were randomly divided into a study group (45 cases) and a control group (45 cases). The control group was treated with Kegel exercise, and the study group was intervened by neuromuscular electrical stimulation on the basis of the control group. The rehabilitation effect, pelvic floor class I and class II muscle strength (μV), muscle fiber contraction time, maximum vaginal pressure, the incidence of stress urinary incontinence, and sexual dysfunction were observed and compared between the two groups. Results The total effective rate of the study group was 95.56%, higher than 82.22% of the control group, the difference was statistically significant (χ2=4.050, P=0.044). After 3 months of intervention, the pelvic floor class I and class II muscle strength, muscle fiber contraction time and maximum vaginal internal pressure in the two groups were significantly higher than those before the intervention (P<0.05). The pelvic floor class I muscle strength in the study group was (4.212±0.351) μV, the muscle strength of class II muscle was (4.983±0.508) μV. The contraction time of class I muscle fiber was (4.383±0.456) s, the contraction time of class II muscle fiber was (4.191±0.494) s, and the maximum vaginal internal pressure was (83.282±4.157) cmH2O, which was higher than those in the control group: (2.023±0.315) μV, (2.314±0.451) μV, (3.264±0.418) s, (3.053±0.412) s, and (73.355±4.260) cmH2O, and there were significant differences (t=31.421, 26.626, 12.342, 11.970, 11.201, all P<0.001). After the intervention, the incidence of stress urinary incontinence and sexual dysfunction in the study group was 4.44% and 35.56% respectively, lower than 22.22% and 57.78% in the control group (χ2=6.154, 4.464, P=0.013, 0.035). Conclusion The neuromuscular electrical stimulation combined with Kegel exercise can effectively enhance pelvic floor muscle strength and prolong muscle fiber in postpartum FPFD patients.