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目的观察腹腔镜和腹式子宫切除患者术后发现盆底肌力减退后,采用生物反馈联合电刺激的治疗效果。方法选取术后3个月复诊发现重度盆底肌力减退的患者154例,有116例术后接受生物电刺激治疗为治疗组,其中腹腔镜组61例,腹式组55例。应用PHENIX检测仪量化评估盆底肌力后,采用生物反馈联合电刺激治疗10次,在术后6个月和10个月再次检测患者盆底肌力情况。38例未治疗患者作为对照组。结果治疗组患者Ⅰ类肌力和Ⅱ类肌力评分在治疗后较治疗前均有显著增高(P<0.01)。腹腔镜组和腹式组比较,治疗前盆底肌力评分差异无统计学意义(P>0.05),术后6个月两组Ⅰ、Ⅱ类肌力评分比较差异无统计学意义(P>0.05);术后10个月腹腔镜组的Ⅰ、Ⅱ类肌力评分均高于腹式子宫切除组,差异有统计学意义(P<0.05)。腹腔镜组和腹式组治疗后术后6个月与10个月的Ⅰ、Ⅱ类肌力评分均显著高于对照组(P<0.05)。结论生物反馈联合电刺激治疗重度盆底肌力减退疗效显著。对腹式切除子宫发生重度盆底肌力减退患者需要强化疗程。
Objective To observe the therapeutic effect of biofeedback combined with electrical stimulation after pelvic floor muscle weakness found in patients after laparoscopic and abdominal hysterectomy. Methods A total of 154 patients with severe pelvic floor muscle weakness were found on follow-up 3 months after operation, 116 of whom received bioelectrical stimulation after operation. Among them, 61 were in laparoscopic group and 55 in abdominal group. After quantifying the pelvic floor muscle strength with the PHENIX detector, the biofeedback combined with electrical stimulation was used for 10 times, and the pelvic floor muscle strength was tested again 6 months and 10 months after the operation. 38 cases of untreated patients as a control group. Results The scores of type I and type II muscle strength of patients in treatment group were significantly higher than those before treatment (P <0.01). There was no significant difference in pelvic floor muscle strength between the laparoscopic group and the abdominal group before treatment (P> 0.05). There was no significant difference between the two groups in the muscle strength score at the 6th month after operation (P> 0.05). The scores of I and II muscle strength in laparoscopic group at 10 months after operation were significantly higher than those in abdominal hysterectomy group (P <0.05). The I and II muscle strength scores of the laparoscopic group and the abdominal group at 6 and 10 months after operation were significantly higher than those in the control group (P <0.05). Conclusions Biofeedback combined with electrical stimulation is effective in treating severe pelvic floor muscle weakness. Abdominal resection of the uterus severe pelvic floor muscle weakness patients need intensive treatment.