产后盆底肌肉康复治疗尿失禁435例分析

目的：探讨产后盆底肌肉康复治疗对尿失禁等盆底功能障碍康复的临床效果。方法选择产后6～8周尿失禁患者435例，采用尿失禁问卷调查（ ICI－QSF问卷）及性功能问卷调查（ FSFI问卷）对产妇分别进行尿失禁（ SUI）调查、盆腔脏器脱垂（ POP－Q）分度及性生活质量问卷调查。比较盆底康复治疗前后Ⅰ类肌、Ⅱ类肌的肌力和疲劳度、阴道动态压的变化等盆底功能的改变。盆底肌肉康复治疗包括：仿生物电刺激、生物反馈、场景反射训练及Kegel锻炼。结果盆底肌肉康复治疗后，盆底功能明显提高，盆底肌力提高，疲劳度下降，阴道动态压上升：肌电值治疗前（5．6±1．8）μV，治疗8周后（15．1±4．6）μV（t＝3．6，P＜0．05）；阴道动态压治疗前（48．7±11．0）cmH2O，治疗4周后（86．3±5．1）cmH2O（t＝7．2，P＜0．01）；疲劳度明显改善（P＜0．01），尿失禁治疗效果非常明显（t＝5．6，P＜0．05），盆腔脏器脱垂改善明显，阴道前后壁脱垂治疗前Ⅱ度63例、Ⅲ度14例，治疗后Ⅱ度16例、Ⅲ度0例，缓解率82％；子宫脱垂治疗前172例，治疗后39例，缓解率77．3％；性功能得到明显改善，治疗前评分（78．00±20．45）分，治疗后评分（100．00±25．36）分（ t＝8．6，P＜0．01）。结论盆底肌肉康复治疗有效提高产后妇女的盆底功能，可达到治疗尿失禁、改善盆腔脏器脱垂、提高性生活质量的目的。

Analysis the effect of pelvic floor muscle rehabilitation treatment of 43S cases of urinary incontinence

Objective To explore the clinical effect of pelvic floor muscle rehabilitation therapy to recover pelvic floor dysfunction.Methods 435 cases of 6-8 weeks postpartum urinary incontinence patients were chosen.The urinary incontinence questionnaire （ ICI-QSF） ,and Female Sexual Function Index questionnaire （ FSFI questionnaire） were used to detect maternal urinary incontinence （UI） investigation,pelvic organ prolapse （POP-Q） degree and quality of sexual life questionnaire.Ⅰ muscle,Ⅱ muscle strength and fatigue, vaginal and the change of dynamic pressure for pelvic floor functional change before and after Pelvic floor rehabilitation were compared.Pelvic floor mus-cle rehabilitation treatment included：imitation bioelectricity stimulus,biofeedback,scene reflection training and Kegel exercises.Results After pelvic floor muscle rehabilitation,pelvic floor function improved significantly,pelvic floor muscle strength increase, decrease fatigue, vaginal dynamic pressure rose significant difference：Electrical values （μV） before treatment （5.6 ±1.8）,after treatment（15.1 ±4.6）,t =3.6,P 〈0.05;Vaginal dynamic pressure （cmH2O） before treatment（48.7 ±11.0）,after treatment （86.3 ±5.1）cmH2O（t=7.2,P〈0.01）;Fatigue obvi-ously improved,（P〈0.01）,the effect of Urinary incontinence treatment is very obvious （t=5.6,P〈0.05）and pelvic organ prolapse improved significantly：Before treatment vaginal wall prolapse II degrees 63 people,after treat-ment 14 people,remission rate 82%,and Before treatment uterine prolapse 172 people,after treatment uterine pro-lapse 39 people,the response rate of 77.3% （P 〈0.01）,sexual function improved significantly：before treatment score is （78.00 ±20.45） and after treatment scores is （100.00 ±25.36）,t=8.6 （P〈0.01）.Conclusion Pelvic floor muscle rehabilitation effectively improve postpartum women pelvic floor function,can achieve the purpose of the treatment of urinary incontinence,improve pelvic organ prolapse and the