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[电刺激联合生物反馈疗法治疗产后盆腔器官脱垂的效果评估:一项静态和动态磁共振成像研究]

[Evaluation of the effect of electrical stimulation combined with biofeedback therapy for postpartum pelvic organ prolapse: a static and dynamic magnetic resonance imaging study].

作者信息

Wang Q J, Zhao Y J, Huang L X, Zhang J, Shen W

机构信息

Tianjin Medical University First Central Clinical College, Tianjin 300192, China.

Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2019 Jan 29;99(5):375-379. doi: 10.3760/cma.j.issn.0376-2491.2019.05.011.

Abstract

To explore the clinical value of static and dynamic magnetic resonance imaging (MRI) in evaluating the effect of electrical stimulation combined with biofeedback in the treatment of pelvic organ prolapse postpartum. A total of 50 primiparas diagnosed as pelvic organ prolapse postpartum from February 2016 to November 2017 were randomly divided into treatment group (24 cases) and control group (26 cases). The control group recovered spontaneously, and the treatment group received electric stimulation combined with biofeedback therapy (6 weeks). All subjects underwent static and dynamic MRI before and after treatment. The thickness of bilateral puborectal muscles, levator ani hiatus area (LHA), H line, M line and levator ani plate angle (LPA) were respectively measured in rest state and strain state at 42 days and 12 weeks postpartum, and the differences of parameters were compared between two groups. (1) Compared with 42 days postpartum, the effective rate of pelvic organ prolapse was 15.4% (4/26) in the control group and 62.5% (15/24) in the treatment group, which was significantly higher than that of the control group (0.01). (2) Compared with 42 days postpartum, the thickness of bilateral puborectal muscles in the treatment group increased at 12 weeks postpartum, while that of the H line, LHA, M line and LPA in strain state decreased. (3) At 12 weeks postpartum, the thickness of the bilateral puborectal muscle in the treatment group was greater, and LHA, M line, and LPA in strain state were less than that in the control group (all 0.05). Electrical stimulation combined with biofeedback therapy can improve pelvic organ prolapse due to vaginal delivery, and the static and dynamic MRI can objectively evaluate the effect of pelvic floor rehabilitation therapy on improving the pelvic floor supporting structure and function, providing an important support and guidance for restoration of postpartum pelvic organ prolapse.

摘要

探讨静态和动态磁共振成像(MRI)在评估电刺激联合生物反馈治疗产后盆腔器官脱垂效果中的临床价值。选取2016年2月至2017年11月诊断为产后盆腔器官脱垂的50例初产妇,随机分为治疗组(24例)和对照组(26例)。对照组自然恢复,治疗组接受电刺激联合生物反馈治疗(6周)。所有受试者在治疗前后均接受静态和动态MRI检查。分别在产后42天和12周的静息状态和用力状态下测量双侧耻骨直肠肌厚度、肛提肌裂孔面积(LHA)、H线、M线和肛提肌板角(LPA),比较两组参数差异。(1)与产后42天相比,对照组盆腔器官脱垂有效率为15.4%(4/26),治疗组为62.5%(15/24),治疗组显著高于对照组(P<0.01)。(2)与产后42天相比,治疗组产后12周双侧耻骨直肠肌厚度增加,用力状态下H线、LHA、M线和LPA减小。(3)产后12周,治疗组双侧耻骨直肠肌厚度更大,用力状态下LHA、M线和LPA小于对照组(均P<0.05)。电刺激联合生物反馈治疗可改善阴道分娩所致盆腔器官脱垂,静态和动态MRI可客观评估盆底康复治疗对改善盆底支持结构和功能的效果,为产后盆腔器官脱垂的恢复提供重要支持和指导。

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