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目的 探讨以腹横肌为主的核心肌群训练联合盆底生物反馈电刺激与功能性磁刺激治疗盆底功能障碍性疾病(PFD)患者的效果。方法 选取2023年3月—2024年3月在空军军医大学第二附属医院康复医学科就诊的103例产后PDF患者，按照随机数字表分为观察组(52例)和对照组(51例)。对照组给予常规盆底生物反馈电刺激联合功能性磁刺激治疗，观察组在对照组基础上增加以腹横肌为主的核心肌群训练。治疗8周后，比较两组患者的盆底超声检查指标(膀胱颈移动度、盆膈裂孔横径、盆膈裂孔纵径、盆膈裂孔面积)、盆底表面肌电指标(快速收缩阶段最大肌电值、紧张收缩阶段平均肌电值、耐力收缩阶段平均肌电值),并评价两组患者压力性尿失禁(SUI)、盆腔器官脱垂(POP)的疗效。结果 观察组治疗前后膀胱颈移动度分别为(4.76±0.73)cm和(0.99±0.40)cm,盆膈裂孔横径分别为(4.09±0.58)cm和(3.54±0.54)cm,盆膈裂孔纵径分别为(5.70±0.80)cm和(4.42±0.95)cm,盆膈裂孔面积分别为(23.81±3.77)cm2和(15.91±3.26)cm2。对照组治疗前后膀胱颈移动度分别为(4.86±0.70)cm和(1.45±0.48)cm,盆膈裂孔横径分别为(4.27±0.61)cm和(3.85±0.57)cm,盆膈裂孔纵径分别为(5.76±0.83)cm和(4.92±0.71)cm,盆膈裂孔面积分别为(24.41±3.52)cm2和(17.43±2.52)cm2。治疗后，两组患者膀胱颈移动度、盆膈裂孔横径、盆膈裂孔纵径及盆膈裂孔面积均降低，且观察组均低于对照组(均P<0.05)。观察组治疗前后快速收缩阶段最大肌电值分别为(28.96±4.96)μV和(37.45±5.91)μV,紧张收缩阶段平均肌电值分别为(15.85±2.71)μV和(24.22±5.19)μV,耐力收缩阶段平均肌电值分别为(14.90±2.38)μV和(24.73±4.01)μV。对照组治疗前后快速收缩阶段最大肌电值分别为(29.25±4.29)μV和(33.39±7.36)μV,紧张收缩阶段平均肌电值分别为(16.09±2.35)μV和(21.86±4.07)μV,耐力收缩阶段平均肌电值分别为(15.11±2.06)μV和(23.03±4.50)μV。治疗后，两组患者快速收缩阶段最大肌电值、紧张收缩阶段平均肌电值及耐力收缩阶段平均肌电值均升高，且观察组均高于对照组(均P<0.05)。观察组治疗SUI的有效率(94.29%)显著高于对照组(75.00%),差异有统计学意义(χ2=4.897,P<0.05)。观察组治疗POP的总有效率(97.96%)显著高于对照组(82.98%),差异有统计学意义(χ2=6.337,P<0.05)。结论 采用以腹横肌为主的核心肌群训练联合盆底生物反馈电刺激与功能性磁刺激治疗PFD患者的效果显著，可有效改善盆底功能、减轻SUI、POP症状。
Abstract：Objective To explore the effect of core muscle group training focusing on transverse abdominis combined with pelvic floor biofeedback electrical stimulation and functional magnetic stimulation in treatment of patients with pelvic floor dysfunction(PFD).Methods A total of 103 postpartum PDF patients who visited Department of Rehabilitation Medicine, the Second Affiliated Hospital of Air Force Medical University from March 2023 to March 2024 were selected and divided into observation group(52 cases) and control group(51 cases) according to random number table.The patients in control group were given conventional pelvic floor biofeedback electrical stimulation combined with functional magnetic stimulation treatment, while the patients in observation group were given core muscle group training focusing on transverse abdominis muscle on the basis of control group.After 8 weeks of treatment, pelvic floor ultrasound examination indicators(bladder neck mobility, transverse diameter of pelvic diaphragmatic hiatus, longitudinal diameter of pelvic diaphragmatic hiatus, and area of pelvic diaphragmatic hiatus) and pelvic floor surface electromyography indicators(maximum electromyography value in the rapid contraction stage, average electromyography value in the tense contraction stage, and average electromyography value in the endurance contraction stage) in the two groups were compared.The therapeutic effects for stress urinary incontinence(SUI) and pelvic organ prolapse(POP) in the two groups were evaluated.Results Bladder neck mobility in observation group before and after treatment were(4.76±0.73) cm and(0.99±0.40) cm, respectively, transverse diameters of pelvic diaphragmatic hiatus were(4.09±0.58) cm and(3.54±0.54) cm, respectively, and longitudinal diameters of pelvic diaphragmatic hiatus were(5.70±0.80) cm and(4.42±0.95) cm, respectively, areas of pelvic diaphragmatic hiatus were(23.81±3.77) cm2 and(15.91±3.26) cm2, respectively.Bladder neck mobility in control group before and after treatment were(4.86±0.70) cm and(1.45±0.48) cm, respectively, transverse diameters of pelvic diaphragmatic hiatus were(4.27±0.61) cm and(3.85±0.57) cm, respectively, and longitudinal diameters of pelvic diaphragmatic hiatus were(5.76±0.83) cm and(4.92±0.71) cm, respectively, areas of pelvic diaphragmatic hiatus were(24.41±3.52) cm2 and(17.43±2.52) cm2, respectively.After treatment, bladder neck mobility, transverse diameter of pelvic diaphragmatic hiatus, longitudinal diameter of pelvic diaphragmatic hiatus, and area of pelvic diaphragmatic hiatus in the two groups decreased, and those in observation group were lower than those in control group(all P<0.05).Maximum electromyography value in the rapid contraction stage in observation group before and after treatment were(28.96±4.96) μV and(37.45±5.91) μV, respectively, average electromyography value in the tense contraction stage were(15.85±2.71) μV and(24.22±5.19) μV, respectively, and average electromyography value in the endurance contraction stage were(14.90±2.38) μV and(24.73±4.01) μV, respectively.Maximum electromyography value in the rapid contraction stage in control before and after treatment were(29.25±4.29) μV and(33.39±7.36) μV, respectively, average electromyography value in the tense contraction stage were(16.09±2.35) μV and(21.86±4.07) μV, respectively, and average electromyography value in the endurance contraction stage were(15.11±2.06) μV and(23.03±4.50) μV, respectively.After treatment, maximum electromyography value in the rapid contraction stage, average electromyography value in the tense contraction stage, and average electromyography value in the endurance contraction stage increased in the two groups, and the values in observation group were higher than those in control group(all P<0.05).The effective rate of SUI treatment in observation group(94.29%) was higher than that in control group(75.00%), and the difference was statistically significant(χ2=4.897, P<0.05).The total effective rate of POP treatment in observation group(97.96%) was higher than that in control group(82.98%), and the difference was statistically significant(χ2=6.337, P<0.05).Conclusion The effect of core muscle group training focusing on transverse abdominis combined with pelvic floor biofeedback electrical stimulation and functional magnetic stimulation in treatment of PFD is significant, which can effectively improve pelvic floor function and alleviate the symptoms of SUI and POP.
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基本信息:
DOI：10.19829/j.zgfybj.issn.1001-4411.2026.03.001
中图分类号:R711.5
引用信息:
[1]石宪,赵雨亭,刘睿,等.核心肌群训练联合盆底生物反馈电刺激与功能性磁刺激治疗盆底功能障碍性疾病患者的效果分析[J].中国妇幼保健,2026,41(03):389-394.DOI:10.19829/j.zgfybj.issn.1001-4411.2026.03.001.
基金信息:
陕西省重点研发计划一般项目社会发展领域基金(2020SF-124)
2026-01-30
2026-01-30