| Background and ObjectiveFemale pelvic floor tissue is composed of multiple muscles and fascia similar to hammock structure,not only to maintain the normal position of pelvic organs,but also to maintain physiological functions such as urination,defecation and sexual pleasure.Once the pelvic floor structure can no longer maintain its supporting function for a variety of reasons,pelvic floor dysfunction occurs.The main symptoms of pelvic floor functional disorder(PFD)included pelvic organ prolapse(POP),urinary incontinence(UI)and female sexual dysfunction(FSD).As a common disease in middle-aged and elderly women,the exact pathogenesis of PFD has not been cleared,but its pathogenesis factors are varied.According to the epidemiological survey,pregnancy and childbirth are particularly important.Therefore,in postpartum women,it is more important to identify early,treat early,choose treatment means and evaluate efficacy.The main imaging methods for clinical evaluation of pelvic floor structure and function include pelvic floor ultrasound,CT and MRI,etc.Pelvic floor ultrasound,with its characteristic of dynamic observation of the pelvic floor,has become the most commonly used clinical means for pelvic floor function examination at present,and can reflect the structural changes of the pelvic floor before and after treatment.Before the symptoms of PFD,pelvic floor EMG signals have been abnormal,and pelvic floor EMG,as a means to objectively display the electrical signals of pelvic floor muscle fibers,can help to screen the occurrence of asymptomatic PFD and evaluate the efficacy of pelvic floor therapy.Elvic floor treatment is varied,while primiparas mostly have mild or early PFD,and rehabilitation treatment is the main choice.In pelvic floor rehabilitation therapy,magnetic stimulation therapy is an emerging treatment method,but there are few relevant researches at home and abroad.The purpose of this study is to evaluate and compare the efficacy of pelvic floor magnetic stimulation and bioelectrical feedback in the pelvic floor rehabilitation process of postpartum women by using pelvic floor three-dimensional ultrasound combined with pelvic floor electrophysiology,so as to find out efficient and more suitable rehabilitation treatment for patients,and provide a high basis for clinical efficacy evaluation.Materials and Methods1.MaterialsThis study mainly selected primiparas who were screened for pelvic floor function,diagnosed with pelvic floor dysfunction and treated in the pelvic floor rehabilitation clinic of the Second Affiliated Hospital of Zhengzhou University from January 2019 to December 2019.According to the different treatment methods,they were divided into 2 groups.Bioelectric feedback treatment patients were included in the control group,and magnetic stimulation treatment patients were included in the control group.Among them,207 patients with complete data were included in the control group(102 cases)and the experimental group(105 cases).,there was no statistical difference in general basic information between the two groups.Before treatment(42d postpartum)and after treatment(3 months postpartum),pelvic floor electrophysiological test,pelvic floor three-dimensional ultrasound,the rate of abnormal muscle strength,the incidence of organ prolapse,the incidence of stress urinary incontinence,and ICIQ-SF brief form were completed in the two groups,respectively.2.Statistieal methodsTatistical software SPSS21.0 was used for data processing and analysis.If the measurement data were in line with the normal distribution,((?)±s)was used to describe the measurement data,and the t-test was used for comparison between groups.If the variance of two groups of data was uniform,the t-test of two independent samples was used.If the variance is not uniform,use the corrected t test.Paired sample t test was used for comparison before and after treatment.Enumeration data were described by N(%),and differences were compared byχ~2test.P<0.05was considered statistically significant.Results1.Pelvic floor muscle electrophysiological assessment:The international GLAZER evaluation procedure was used to capture the electrical signals of the pelvic floor muscle fibers at the pre-resting,fast,slow and post-resting stages by using the pelvic floor rehabilitation instrument produced by Mailande Company,and then the component values were quantified for statistical analysis.Before treatment,there was no statistical significance in the scores of electrical signals of pelvic floor muscle fibers at various stages between 2 groups(all P>0.05).After treatment,the scores were increased,with statistical significance(P<0.05).Compared with the control group before and after treatment,the increase of electrical signal score in fast muscle stage was not statistically significant(t=0.957,P=0.341),while the increase of other scores was statistically significant(t=6.542,P<0.001;t=6.715,P<0.001;t=3.658,P<0.001);Compared with the experimental group before and after treatment,the scores increased after treatment,the difference was statistically significant(t=0.641,P<0.001;t=5.696,P<0.001;t=8.503,P<0.001;t=6.489,P<0.001);2.Before treatment,there was no significant difference in the rate of abnormal pelvic floor muscle strength between 2 groups(χ~2=1.295,P=0.255).After treatment,the rate of abnormal pelvic floor muscle strength decreased in both groups,and the difference was statistically significant(experimental groupχ~2=119.964,P<0.001;χ~2=53.292,P<0.001),and the abnormal rate of pelvic floor muscle strength in the experimental group was significantly lower than that in the control group,the difference was statistically significant(χ~2=26.469,P<0.001);3.There was no statistical significance in the incidence of POP,SUI and ICIQ-SF scores between the two groups before treatment.After treatment,the incidence of POP,SUI and ICIQ-SF score in 2 groups were significantly decreased,and the indexes of the experimental group were significantly lower than the control group,the difference was statistically significant(P>0.05);4.Patients with pelvic floor under the three dimensional ultrasound measurement Valsalva action under the bladder neck movement,urethra rotation and anal levator hiatal area,statistical analysis showed that:the two groups before treatment in patients with bladder neck movement,urethra rotation Angle and anus levator fissure area index compared differences no statistical significance(P>0.05),and each index improved significantly after treatment,the difference was statistically significant(P<0.05),and improve the experimental group is better than that of control group(P<0.05).Conclusions1.Using pelvic floor three-dimensional ultrasound and pelvic floor electrophysiological assessment,it was found that both bioelectrical feedback and pelvic floor magnetic stimulation therapy could improve the symptoms of pelvic floor dysfunction in postpartum women and improve the quality of life of the patients.By comparison,it was concluded that magnetic stimulation was superior to bioelectrical feedback therapy in improving pelvic floor electrophysiological and pelvic floor structure.;2.Pelvic floor three-dimensional ultrasound and pelvic floor electrophysiology provide objective indicators and reliable basis for the efficacy of pelvic floor rehabilitation,which has certain significance for improving patients’consciousness and confidence in rehabilitation treatment and guiding clinical practice. |
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