标题：盆底磁刺激、生物电刺激联合盆底康复训练在产后阴道松弛症中的应用

      作者：张晶，王爱玲，石晨星，孙倩倩    焦作市妇幼保健院盆底康复中心产后保健科，河南 焦作 454000

      卷次： 2023年34卷13期

      【摘要】 目的 探讨盆底磁刺激、生物电刺激联合盆底康复训练在阴道松弛症中的应用价值，以期为临床改善产后女性生活质量提供依据。方法 选取2021年1月至2022年1月焦作市妇幼保健院盆底康复产后保健科收治的102例产后阴道松弛症患者作为研究对象，按随机数表法分为常规康复组和联合康复组，每组51例。常规康复组产后42 d开始进行常规康复措施，联合康复组在常规康复组的基础上实施盆底磁刺激、生物电刺激联合盆底康复训练。产后42 d、产后2个月、产后4个月分别比较两组患者的阴道松弛度、盆底肌肌电压、盆底肌力、性功能(FSFI)评分、血清松弛素(RLX)水平及性生活满意度。结果 联合康复组患者产后2个月和产后4个月的阴道松弛度为重度者占比分别为23.53%、1.96%，明显低于常规康复组的37.25%和19.61%，差异均有统计学意义(P<0.05)；联合康复组患者产后2个月Ⅰ类和Ⅱ类肌纤维肌电压、快肌和慢肌状态下盆底肌肌力分别为(5.87±0.42) μV、(6.85±0.47) μV、(46.10±3.52) μV、(41.25±3.79) μV，产后4个月Ⅰ类和Ⅱ类肌纤维肌电压、快肌和慢肌状态下盆底肌肌力分别为(9.01±1.32) μV、(9.79±1.87) μV、(53.47±6.10) μV、(50.32±5.78) μV，明显高于常规康复组患者产后 2个月的(4.63±0.48) μV、(5.63±0.52) μV、(43.10±4.34) μV、(37.11±4.10) μV和产后 4个月的(6.85±1.20) μV、(6.85±1.63) μV、(48.10±5.78) μV、(43.62±4.46) μV，差异均有统计学意义(P<0.05)；联合康复组患者产后2个月和产后4个月的状态下盆底肌肌力分别为(4.85±1.10) μV、(3.28±1.06) μV，明显低于常规康复组的(5.63±1.23) μV、(4.52±1.10) μV，差异均有统计学意义(P<0.05)；产后4个月，联合康复组患者的RLX水平为(46.52±8.10) pg/mL，明显低于常规康复组的(50.85±7.82) pg/mL，差异有统计学意义(P<0.05)；干预结束后，联合康复组患者的性生活满意度为94.12%，明显高于常规康复组的68.63%，差异有统计学意义(P<0.05)。结论 盆底磁刺激、生物电刺激联合盆底康复训练治疗能有效改善产后阴道松弛症患者的盆底肌功能，调节RLX水平，减轻阴道松弛度，有效恢复患者性功能，并改善性生活质量。
      【关键词】 产后阴道松弛症；盆底磁刺激；生物电刺激；盆底康复训练；盆底肌力
      【中图分类号】 R714.46 【文献标识码】 A 【文章编号】 1003—6350（2023）13—1888—05

Application of pelvic floor magnetic stimulation, bioelectric stimulation combined with pelvic floor rehabilitationtraining in patients with postpartum vaginal relaxation.
ZHANG Jing, WANG Ai-ling, SHI Chen-xing, SUNQian-qian. Department of Postpartum health care, Pelvic floor Rehabilitation Center, Jiaozuo Maternal and Child HealthCare Hospital, Jiaozuo 454000, Henan, CHINA
【Abstract】 Objective To explore the application value of pelvic floor magnetic stimulation, bioelectric stimula-tion combined with pelvic floor rehabilitation training in patients with vaginal relaxation, in order to provide basis for clini-cal improvement of postpartum women's quality of life.Methods One hundred and two patients with postpartum vaginalrelaxation admitted to the Postpartum Health Care Department, Pelvic Floor Rehabilitation Center, Jiaozuo Maternal andChild Health Hospital from January 2021 to January 2022 were selected as the research objects. They were randomly di-vided into conventional rehabilitation group and combined rehabilitation group according to random number table, with51 patients in each group. Patients in the conventional rehabilitation group received routine rehabilitation measures after42 days of postpartum, and those in the combined rehabilitation group were treated with pelvic floor magnetic stimulation,bioelectric stimulation, and pelvic floor rehabilitation training on the basis of the conventional rehabilitation group. After42 days, 2 months and 4 months of postpartum, the vaginal relaxation, pelvic floor muscle voltage, pelvic floor musclestrength, sexual function (FSFI) score, serum relaxin (RLX) level, and sexual life satisfaction were compared between thetwo groups. Results The proportion of severe vaginal relaxation in the combined rehabilitation group at 2 months and4 months postpartum were 23.53% and 1.96%, respectively, which were significantly lower than 37.25% and 19.61% inthe conventional rehabilitation group (P<0.05); the muscle voltage of class Ⅰ and class Ⅱ muscle fibers, the musclestrength of pelvic floor under fast and slow muscle conditions in the combined rehabilitation group were (5.87±0.42) μV,(6.85±0.47) μV, (46.10±3.52) μV, (41.25±3.79) μV at 2 months postpartum and (9.01±1.32) μV, (9.79±1.87) μV, (53.47±6.10) μV, (50.32±5.78) μV at 4 months postpartum, which were significantly higher than (4.63±0.48) μV, (5.63±0.52) μV,(43.10±4.34) μV, (37.11±4.10) μV at 2 months postpartum and (6.85±1.20) μV, (6.85±1.63) μV, (48.10±5.78) μV, (43.62±4.46) μV at 4 months postpartum in the conventional rehabilitation group (P<0.05). The pelvic floor muscle strength inthe combined rehabilitation group at 2 months and 4 months postpartum were (4.85±1.10) μV and (3.28±1.06) μV, respec-tively, which were significantly lower than (5.63±1.23) μV and (4.52±1.10) μV in the conventional rehabilitation group (P<0.05). After 4 months of postpartum, the level of RLX in the combined rehabilitation group was (46.52±8.10) pg/mL,which was significantly lower than (50.85±7.82) pg/mL in the conventional rehabilitation group (P<0.05). After the inter-vention, the sexual life satisfaction of the combined rehabilitation group (94.12%) was significantly higher than that ofthe conventional rehabilitation group (68.63% ), P<0.05. Conclusion Pelvic floor magnetic stimulation, bioelectricstimulation combined with pelvic floor rehabilitation training can effectively improve the pelvic floor muscle function ofpostpartum vaginal relaxation, regulate the level of RLX, reduce vaginal relaxation, effectively restore the sexual func-tion of patients, and improve the quality of sexual life.
      【Key words】 Postpartum vaginal relaxation; Pelvic floor rehabilitation training; Bioelectric stimulation; Pelvicfloor rehabilitation training; Pelvic floor muscle strength