文章摘要
王耀苹,佟玉静,王坤.普拉提联合盆底康复训练对青年宫颈癌根治术后尿失禁患者盆底肌张力及性功能的影响[J].中国康复,2024,39(5):292-297
普拉提联合盆底康复训练对青年宫颈癌根治术后尿失禁患者盆底肌张力及性功能的影响
Effect of Pilates combined with pelvic floor rehabilitation training on pelvic floor muscle tension and sexual function in young patients with urinary incontinence after radical cervical cancer surgery
  
DOI:
中文关键词: 普拉提  盆底康复训练  宫颈癌  尿失禁  盆底肌张力  性功能
英文关键词: pilates  pelvic floor rehabilitation training  cervical cancer  urinary incontinence  pelvic floor muscle tension  sexual function
基金项目:河北医学科研究重点课题计划(20201527)
作者单位
王耀苹 唐山市人民医院妇一产科河北 唐山063000 
佟玉静 唐山市人民医院妇一产科河北 唐山063000 
王坤 唐山市人民医院妇一产科河北 唐山063000 
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中文摘要:
  目的:探究普拉提联合盆底康复训练对青年宫颈癌根治术后尿失禁患者盆底肌张力及性功能的影响。方法:选前瞻性收集我院2022年1月~2023年1月宫颈癌术后尿失禁患者132例,按照随机数字表法将患者分为观察组和对照组各66例,对照组给予常规盆底康复训练,观察组实施普拉提联合盆底康复训练。对比2组患者术前、术后1周、术后13周膀胱功能(储尿时和排尿时的膀胱压、尿道分布压,采用牛津评分法(MOS)评估盆底肌张力;评估女性性功能指数量表(FSFI)评分;采用Kolcaba舒适度量表对舒适度进行评估比较,并观察术后并发症情况。结果:2组术前、术后1周时,储尿时及排尿时的膀胱压、尿道分布压组内及组间比较均无统计学差异,2组术后13周时储尿时的膀胱压、尿道分布压以及排尿时的膀胱压高于术前、术后1周时,排尿时尿道分布压低于术前及术后1周时(均P<0.05);观察组患者术后13周时膀胱功能储尿时的膀胱压、尿道分布压以及排尿时的膀胱压均高于对照组,排尿时尿道分布压低于对照组(均P<0.05);2组患者术前及术后1周时Ⅰ、Ⅱ类肌纤维肌张力比较无统计学差异,术后13周时Ⅰ、Ⅱ类肌纤维肌张力较术前、术后1周时均有所升高(P<0.05),且观察组明显高于对照组(P<0.05);随着治疗时间的延长2组性交痛评分逐渐降低,观察组明显低于对照组,其余各纬度及总分评分随着治疗时间的延长逐渐升高,观察组明显高于对照组,差异均具有统计学意义(均P<0.05);术后13周,观察组患者的舒适度65/66(98.48%)显著高于对照组42/66(63.64%)(P<0.05)。观察组术后并发症发生率(9.09%)显著低于对照组(P<0.05)。结论:普拉提联合盆底康复训练对青年宫颈癌根治术后尿失禁患者提高盆底肌张力和性功能,降低了术后并发症的发生率。
英文摘要:
  Objective: To investigate the effect of Pilates combined with pelvic floor rehabilitation training on pelvic floor muscle tension and sexual function in young patients with urinary incontinence after radical cervical cancer surgery. Methods: A prospective collection of 132 postoperative urinary incontinence patients with cervical cancer in our hospital from January 2022 to January 2023 was conducted. The patients were randomly divided into an observation group and a control group, with 66 cases in each group. The control group received routine pelvic floor rehabilitation training. The observation group implemented Pilates combined with pelvic floor rehabilitation training. The bladder functions (bladder pressure during storage and urination, urethral distribution pressure) were compared between two groups. The pelvic floor muscle tone was evaluated using the modified Oxford scale (MOS) and postoperative female sexual function index (FSFI) scores were compared. The comfort level after treatment was compared using the Kolcaba General Comfort Questionnaire (GCQ), and the postoperative complications were observed. Results: Before and 1 week after surgery, there was no statistically significant difference in bladder pressure and urethral distribution pressure during urine storage, as well as bladder pressure and urethral distribution pressure during urination in both groups. At 13th week after surgery, the bladder pressure during urine storage, urethral distribution pressure, and bladder pressure during urination in both groups were increased as compared with those before and 1 week after surgery, while the urethral distribution pressure was reduced as compared with that before and 1 week after surgery (all P<0.05). At 13th week after operation, the bladder pressure during bladder function storage, urethral distribution pressure, and bladder pressure during urination in the observation group were increased as com-pared with those in the control group, while the urethral distribution pressure during urination was lower in the observation group than that in the control group (all P<0.05); There was no statistically significant differ-ence in the strength of class I and II muscle fibers between the two groups before and one week after surgery. At 13th week after surgery, the strength of class I and II muscle fibers increased compared to that before and one week after surgery (P<0.05), and that in the observation group was significantly higher than in the control group (P<0.05). After treatment, with the prolongation of time, the sexual intercourse pain score in the observation group gradually decreased, significantly lower than in the control group. The scores of other dimensions and total scores gradually increased with the prolongation of time, significantly higher in the observation group than in the control group, and the differences were statistically significant (all P<0.05). At 13th weeks post-operation, the GCQ score in the observation group was obviously higher than in the control group (P<0.05). The incidence of postoperative complications in the observation group (9.09%) was significantly lower than that in the control group (P<0.01). Conclusion: Pilates combined with pelvic floor rehabilitation training can improve pelvic floor muscle tension and sexual function in young patients with urinary incontinence after radical cervical cancer surgery, and reduce the incidence of postoperative complications.
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