产后盆底肌电刺激联合生物反馈电诊断及其近期疗效观察

目的:探讨电刺激与生物反馈联合治疗对初产妇顺产后盆底肌的近期影响。方法:选取暨南大学附属第一医院及中山大学附属第二医院门诊2007年1～4月收治的健康初产顺产妇女75例,年龄24～28岁,均为产后42天恶露干净者,盆底肌力Ⅲ级或Ⅲ级以下。随机分为实验组(45例)和对照组(30例),产后实验组产妇给予电刺激与生物反馈联合治疗,每周2次,16次为1疗程,对照组产妇在家自行收肛锻炼治疗。实验观察产妇盆底肌力康复治疗前后的变化,其中26例同意抽血检测胰岛素样生长因子-I(IGF-I)、Na+-K+-ATP酶、Ca2+-ATP酶的变化,观察产妇盆底肌力变化。结果:与对照组比较,经过电刺激和生物反馈联合治疗后实验组产妇的盆底肌力恢复正常(Ⅴ)Ⅰ类纤维39例,ⅡA类纤维36例,ⅡB类纤维37例,对照组0例(P<0.01);实验组产妇IGF-I治疗前后分别是(16.2±5.6)μmol/L和(37.5±7.8)μmol/L,两者比较P<0.01;Na+-K+-ATP酶和Ca2+-ATP酶治疗前分别为(0.134±0.03)μmolPi.mgprot-1.h-1和(0.5±0.12)μmolPi.mgprot-1.h-1,治疗后分别为(0.24±0.09)μmolPi.mgprot-1.h-1和(0.71±0.19)μmolPi.mgprot-1.h-1,两者比较P<0.01。结论:电刺激联合生物反馈治疗能够改善提高产妇产后近期盆底肌力,其作用可能与IGF-I、Na+-K+-ATP酶及Ca2+-ATP酶的明显增加有关。

Diagnosis and observation on the short-term efficacy of postpartum pelvic muscle electrical stimulation combined with biofeedback

Objective:To explore the short-term efficacy of postpartum pelvic muscle electrical stimulation combined with biofeedback on pelvic muscle after spontaneous delivery in primiparous women.Methods:75 healthy primiparous women after spontaneous delivery visiting outpatient department of the First Affiliated Hospital of Jinan University and the Second Affiliated Hospital of Zhongshan University from January to April in 2007 were selected,their ages were from 24 to 28 years,and all of them discharged lochia on the 42nd day after delivery,the stages of pelvic muscle were Ⅲ or below Ⅲ;the primiparous women were divided into study group(45 primiparous women)and control group(30 primiparous women)randomly,the primiparous women in study group received electrical stimulation combined with biofeedback,twice a week,and one course included 16 times;the primiparous women in control group exercised at home;the changes of pelvic muscle before and after treatment were observed;the changes of insulin-like growth factor-I(IGF-I),Na+-K+-ATPase and Ca2+-ATPase in blood of 26 primiparous women were detected,the changes of pelvic muscle were observed.Results:After treatment of electrical stimulation combined with biofeedback,the pelvic muscle of primiparous women in study group recovered to normal,including 39 cases of type Ι fiber,36 cases of type ⅡA fiber and 37 cases of type ⅡB fiber,but in control group,no primiparous women recovered to normal,there was significant difference(P<0.01);in study group,the levels of IGF-I before and after treatment were(16.2±5.6)μmol/L and(37.5±7.8)μmol/L,respectively,there was significant difference(P<0.01),the levels of Na+-K+-ATPase and Ca2+-ATPase were(0.134±0.03)μmol Pi.mg prot-1.h-1 and(0.5±0.12)μmol Pi.mg prot-1.h-1before treatment,(0.24±0.09)μmol Pi.mg prot-1.h-1 and(0.71±0.19)μmol Pi.mg prot-1.h-1 after treatment,there was significant difference(P<0.01).Conclusion:Electrical stimulation combined with biofeedback can improve and increase postpartum pelvic muscle in primiparous women,which may be related to significant increases of Na+-K+-ATPase and Ca2+-ATPase.