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超声生物反馈联合个体化盆底肌训练对绝经后女性盆底肌伸展性及前盆腔器官脱垂的影响。

Effects of Adding Ultrasound Biofeedback to Individualized Pelvic Floor Muscle Training on Extensibility of the Pelvic Floor Muscle and Anterior Pelvic Organ Prolapse in Postmenopausal Women.

机构信息

Department of Ultrasound, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

出版信息

Contrast Media Mol Imaging. 2022 Jun 23;2022:4818011. doi: 10.1155/2022/4818011. eCollection 2022.

Abstract

The aim of the study was to determine effects of adding transperineal ultrasound (TPUS) biofeedback to individualized pelvic floor muscle training (PFMT) on extensibility of the pelvic floor muscle and anterior pelvic organ prolapse (POP) in postmenopausal women. A total of 77 patients with POP at stage I or stage II were admitted to Beijing Shijitan Hospital, China, from January 2017 to October 2018. They were randomly divided into a control group (CG) ( = 37) or a study group (SG) ( = 40). Both SG and CG received a 12-week PFMT including health education, verbal instruction, and home training. However, the SG, but not the CG, received additional TPUS biofeedback. Data of these patients were retrospectively reviewed. The distance from the lowest point of the bladder to the inferior-posterior margin of the symphysis pubis (BSP) and the levator hiatus area (LHA) were measured on maximal Valsalva via TPUS before and after the 12-week PFMT. Correct pelvic floor muscle contraction (PFMC) rates before and after PFMT were compared between the two groups. The correct PFMC rate was higher in the SG than that in the CG (92.5% vs. 73%;  = 5.223, =0.022). The BSP was increased but the LHA was reduced after the 12-week PFMT in both groups compared to those before PFMT (all < 0.05). However, after the PFMT, the SG showed greater improvement than the CG for both BSP (0.77 ± 0.71 cm vs. 0.11 ± 0.66 cm, < 0.05) and LHA (20.69 ± 2.77 cm vs. 22.85 ± 3.98 cm, < 0.05). TPUS might be an effective biofeedback tool for PFMT in clinical practice. Individualized PFMT with TPUS biofeedback could significantly attenuate POP severity and strengthen the extensibility of pelvic floor muscle in postmenopausal women when they are under increased intraabdominal pressure.

摘要

本研究旨在探讨经会阴超声(TPUS)生物反馈联合个体化盆底肌训练(PFMT)对绝经后女性盆底肌伸展性和前盆腔器官脱垂(POP)的影响。2017 年 1 月至 2018 年 10 月,中国北京世纪坛医院收治 77 例Ⅰ期或Ⅱ期 POP 患者,采用随机数字表法分为对照组(CG)(n=37)和研究组(SG)(n=40)。两组均接受 12 周的 PFMT,包括健康教育、口头指导和家庭训练。但 SG 组在接受 PFMT 的同时还接受了额外的 TPUS 生物反馈。回顾性分析这些患者的数据。分别在最大 Valsalva 动作时通过 TPUS 测量膀胱最低点至耻骨联合后下缘(BSP)和肛提肌裂孔面积(LHA)的距离。比较两组患者 PFMT 前后正确盆底肌收缩(PFMC)率。SG 组的 PFMC 率高于 CG 组(92.5%比 73%, =5.223, =0.022)。与 PFMT 前相比,两组患者在接受 12 周 PFMT 后 BSP 增加,LHA 减少(均 < 0.05)。然而,与 CG 组相比,SG 组在接受 PFMT 后 BSP(0.77 ± 0.71 cm 比 0.11 ± 0.66 cm, < 0.05)和 LHA(20.69 ± 2.77 cm 比 22.85 ± 3.98 cm, < 0.05)改善更明显。TPUS 可能是 PFMT 的一种有效的生物反馈工具。在增加腹内压时,个体化 PFMT 联合 TPUS 生物反馈可显著减轻绝经后女性 POP 的严重程度,增强盆底肌的伸展性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7df3/9246575/0c3e3afd8660/CMMI2022-4818011.001.jpg

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