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目的对比盆底重建术联合肌电生物反馈疗法和阴式全子宫切除术联合肌电生物反馈疗法进行盆底复健疗效。方法随机将淮南市第一人民医院2010-2014年收治的重度盆腔器官脱垂(POP)患者45例分为观察组20例,自愿行Prolift全盆底重建术,术后3月行盆底肌电生物反馈治疗。对照组25例,行阴式全子宫切除+阴道前后壁修补术,术后3月行盆底肌电生物反馈治疗。术后12月随访两组盆底肌电位值、POP-Q分度、PISQ-12评分、1 h尿垫试验。结果对照组治疗后仅Ⅱ类肌纤维电位值比治疗前提高,差异有统计学意义(P<0.05),PISQ-12评分治疗后比治疗前提高,尤以生理评分增高明显(P<0.05)。观察组治疗后盆底Ⅰ、Ⅱ、混合类肌纤维电位值比治疗前明显上升,差异有统计学意义(P<0.05),POP-Q分度、1 h尿垫试验改善较对照组更明显,差异有统计学意义(P<0.05)。结论盆底重建术联合肌电生物反馈疗法更能提升盆底肌力,促进盆底复健,改善患者生活质量。
Objective To compare pelvic floor reconstruction with EMG biofeedback therapy and vaginal hysterectomy combined with myoelectric biofeedback therapy for pelvic floor rehabilitation. Methods Forty-five patients with severe pelvic organ prolapse (POP) admitted from 2010 to 2014 in Huainan First People’s Hospital were randomly divided into observation group (n = 20) and Prolift pelvic floor reconstruction Electrobiology feedback treatment. Control group of 25 patients underwent vaginal hysterectomy + vaginal anterior and posterior wall repair, postoperative pelvic floor myoelectric biofeedback therapy. The pelvic floor electromyogram, POP-Q index, PISQ-12 score and urine test for 1 h were followed up in 12 months postoperatively. Results After treatment, only Group Ⅱ myofibril potential increased compared with that before treatment (P <0.05). PISQ-12 improved more significantly than before treatment, especially when the physiological score increased significantly (P <0.05). Observed group after treatment pelvic floor Ⅰ, Ⅱ, mixed muscle fiber potential value increased significantly than before treatment, the difference was statistically significant (P <0.05), POP-Q index, 1h urine pad test to improve more obvious than the control group, The difference was statistically significant (P <0.05). Conclusions pelvic floor reconstruction combined with electromyography biofeedback therapy can enhance pelvic floor muscle strength, promote pelvic floor rehabilitation, improve patient quality of life.