彭其才　张　媛　李志敏　高丽仪　侯红瑛中山大学附属第三医院产科，广东广州　510630

电子生物反馈治疗对产后妇女盆底功能康复的疗效分析

彭其才张媛李志敏高丽仪侯红瑛
中山大学附属第三医院产科，广东广州510630

目的 探讨电子生物反馈治疗对产后妇女盆底功能康复的疗效。方法 选择2011年1~12月在本院第一胎足月产产妇，产后6~8周门诊复查，进行盆底肌力检测，检查尿失禁和阴道口闭合情况。对Ⅰ类肌纤维肌力小于3级和Ⅱ类肌纤维肌力小于3级者共363例进行电子生物反馈治疗。比较治疗前后的肌纤维肌力受损率及阴道口闭合率。结果 治疗前和治疗后产妇Ⅰ类肌纤维肌力受损率分别为98.3%（357/363）和1.1%（4/363），Ⅱ类肌纤维肌力受损率分别为98.6%（358/363）和1.1%（4/363），治疗前后比较，差异有高度统计学意义（P<0.01）；治疗前产妇尿失禁46例，治疗后产妇尿失禁基本治愈，两组比较差异有高度统计学意义（P<0.01）；产妇治疗前和治疗后阴道口闭合率分别是28.1%和59.8%，差异有高度统计学意义（P<0.01）。结论 电子生物反馈治疗对产后妇女盆底功能康复有显著疗效,可以显著增强盆底肌力、促进阴道口闭合,治愈妇女产后张力性尿失禁,提高妇女产后生活质量。

生物反馈治疗；Ⅰ类肌纤维；Ⅱ类肌纤维；张力性尿失禁

[Abstract]Objective To explore the curative effects of electronic biofeedback therapy on rehabilitation of pelvic floor function in postpartum women.Methods Puerpera who gave birth to the first full-term child in our hospital from January to December 2011 were selected.They were re-examined in the outpatient clinic 6-8 weeks after delivery.Pelvic floor muscle strength was tested,and urinary incontinence and closure of orificium vaginae were examined.A total of 363 women whose muscle strength of class I muscle fiber was less than level 3 and whose muscle strength of class II muscle fiber was less than level 3 were given electronic biofeedback therapy.Damage rate of muscle strength of muscle fiber and closure rate of orificium vaginae were compared before and after the treatment.Results Damage rate of muscle strength of class I muscle fiber in puerpera before and after the treatment was 98.3%(357/363)and 1.1%(4/363)respectively,and damage rate of muscle strength of class II muscle fiber was 98.6%(358/363)and 1.1%(4/363)respectively.The differences before and after the treatment were significant(P<0.01);urinary incontinence before the treatment in puerpera was 46 cases respectively,and urinary incontinence after the treatment was basically cured.The differences between the two groups were significant(P<0.01);closure rate of orificium vaginae before and after the treatment in puerpera was 28.1%and 59.8%respectively,and the differences before and after the treatment were significant(P<0.01). Conclusion Electronic biofeedback therapy has significant curative effects on the rehabilitation of pelvic floor function in postpartum women,which is able to significantly improve and enhance pelvic floor muscle strength,promote the closure of orificium vaginae,cure postpartum stress urinary incontinence,and improve postpartum life quality.

[Key words]Biofeedback therapy;ClassⅠmuscle fiber;ClassⅡmuscle fiber;Stress urinary incontinence

流行病学调查显示，妊娠、阴道分娩和年龄是女性盆底功能障碍（pelvic flour dysfunction，PFD）的主要危险因素[1-3]。妊娠、阴道分娩引致的盆底肌肉和神经损伤通常是可复性的。分娩后，盆底大量结缔组织通过胶原蛋白和弹性蛋白合成的增加进行修复，而这些新生组织并不像原组织坚韧并富有弹性[4]，从而导致了盆底组织的重构缺陷。如何更好更快地恢复产后妇女盆底功能,提高产后妇女的生活质量,是产科母胎医学的一个重要课题。本研究对产后盆底功能康复不良的妇女采用电子生物反馈治疗，现报道如下。

1　资料与方法

1.1一般资料

选择2011年1~12月在本院第一胎足月产产妇，产后6~8周门诊复查，进行盆底肌力检测，并检查尿失禁和阴道口闭合情况。……