妇产与遗传（电子版）
婦產與遺傳（電子版）
부산여유전（전자판）
Obstetrics-Gynecology and Genetics(Electronic Edition)
2014年
2期
21-24
,共4页
陈向东%柳晓春%郑玉华%谢庆煌
陳嚮東%柳曉春%鄭玉華%謝慶煌
진향동%류효춘%정옥화%사경황
阴式全宫切除术%盆底训练%盆底功能障碍%尿失禁
陰式全宮切除術%盆底訓練%盆底功能障礙%尿失禁
음식전궁절제술%분저훈련%분저공능장애%뇨실금
total hysterectomy via vaginal%pelvic floor traning%pelvic floor dysfunction%uroclepsia
目的：了解经阴道全子宫切除术后早期盆底训练对预防盆底功能障碍的临床价值。方法选择2007年至2013年南方医科大学附属佛山市妇幼保健院收治的580例因非子宫脱垂的子宫良性疾病行阴式全子宫切除术的患者，随机分为A组（298例）及B组（292例）。A组患者术后1个月采用PHENIX神经肌肉刺激治疗仪进行盆底肌肉训练，B组患者进行一般随访。比较患者术后1个月、6个月和12个月盆底肌肉张力、尿动力学检测、阴道顶端脱垂情况、阴道前后壁膨出情况。结果两组患者术后1个月盆底肌肉张力、尿动力学检查无显著差异（P>0.05），均无阴道顶端脱垂及阴道前后壁膨出；术后6个月和12个月A组盆底肌肉张力，包括阴道静态、动态张力，阴道收缩力均高于B组，差异有高度统计学意义（P<0.01）；A组患者尿失禁发生率低于B组患者，差异有统计学意义（P<0.05）；A组患者阴道顶端脱垂情况、阴道前后壁膨出情况少于B组患者，差异有统计学意义（P<0.05）。结论阴式全子宫切除术后早期盆底训练对预防盆底功能障碍是有效的。
目的：瞭解經陰道全子宮切除術後早期盆底訓練對預防盆底功能障礙的臨床價值。方法選擇2007年至2013年南方醫科大學附屬彿山市婦幼保健院收治的580例因非子宮脫垂的子宮良性疾病行陰式全子宮切除術的患者，隨機分為A組（298例）及B組（292例）。A組患者術後1箇月採用PHENIX神經肌肉刺激治療儀進行盆底肌肉訓練，B組患者進行一般隨訪。比較患者術後1箇月、6箇月和12箇月盆底肌肉張力、尿動力學檢測、陰道頂耑脫垂情況、陰道前後壁膨齣情況。結果兩組患者術後1箇月盆底肌肉張力、尿動力學檢查無顯著差異（P>0.05），均無陰道頂耑脫垂及陰道前後壁膨齣；術後6箇月和12箇月A組盆底肌肉張力，包括陰道靜態、動態張力，陰道收縮力均高于B組，差異有高度統計學意義（P<0.01）；A組患者尿失禁髮生率低于B組患者，差異有統計學意義（P<0.05）；A組患者陰道頂耑脫垂情況、陰道前後壁膨齣情況少于B組患者，差異有統計學意義（P<0.05）。結論陰式全子宮切除術後早期盆底訓練對預防盆底功能障礙是有效的。
목적：료해경음도전자궁절제술후조기분저훈련대예방분저공능장애적림상개치。방법선택2007년지2013년남방의과대학부속불산시부유보건원수치적580례인비자궁탈수적자궁량성질병행음식전자궁절제술적환자，수궤분위A조（298례）급B조（292례）。A조환자술후1개월채용PHENIX신경기육자격치료의진행분저기육훈련，B조환자진행일반수방。비교환자술후1개월、6개월화12개월분저기육장력、뇨동역학검측、음도정단탈수정황、음도전후벽팽출정황。결과량조환자술후1개월분저기육장력、뇨동역학검사무현저차이（P>0.05），균무음도정단탈수급음도전후벽팽출；술후6개월화12개월A조분저기육장력，포괄음도정태、동태장력，음도수축력균고우B조，차이유고도통계학의의（P<0.01）；A조환자뇨실금발생솔저우B조환자，차이유통계학의의（P<0.05）；A조환자음도정단탈수정황、음도전후벽팽출정황소우B조환자，차이유통계학의의（P<0.05）。결론음식전자궁절제술후조기분저훈련대예방분저공능장애시유효적。
Objective To explore the value of pelvic floor training to prevent pelvic floor dysfunction at early post-operative stage of total hysterectomy via vaginal. Methods Choosing 580 cases who undergone the total hysterectomy via vaginal surgery excluded those with the uterine prolapse, all were hospitalized in Foshan maternal and child care service centre which affiliated of Southern medical university from 2007 to 2013.All patients were randomly divided into group A (298 cases) and group B (n=292). Group A use PHENIX neuromuscular stimulation therapy apparatus for pelvic floor muscle training at one month after operative, group Bfollows as usual without the therapy above. Comparing the situation of pelvic floor muscle tension, urine dynamics before and after the test, the top of the vaginal prolapse, vaginal wall surfaces in 1 month, 6 months and 12 months of post-operative. Results The difference of pelvic floor muscle tension, urine dynamics test results in 1 month of post-operative between the two groups is no statistical significant (P>0.05). Both have no the top and the Anterior and posterior vaginal encephalocele; At 6 month and 12 month ofpost-operative, the pelvic floor muscle tension like vaginal static, dynamic tension, vaginal contraction force of group A are higher than that of B group which has highly statistically significant difference (P<0.01); The incidence of urinary incontinence of group A is lower the that of group B, which the difference has statistically significance (P<0.05); The situation of the top and the anterior and posterior vaginal encephalocele of A group is less than that of group B, which the difference has statistically significance (P<0.05). Conclusions It is effective to prevent pelvic floor dysfunction using the pelvic floor training at early post-operative stage of total hysterectomy via vaginal.
