探讨电刺激生物反馈联合凯格尔运动对Ⅱ~Ⅲ度子宫脱垂患者术后康复的影响。

本研究为回顾性队列研究。回顾性分析2020年6月至2024年3月无锡市人民医院收治的90例子宫脱垂患者的病历资料，根据治疗方案的不同分为试验组（n=46，电刺激生物反馈＋凯格尔运动）与对照组（n=44，凯格尔运动）。比较2组患者的围手术期指标、内分泌相关因子水平、盆底结构参数、盆底肌电生理指标、盆底肌力、排尿功能、生活质量评分、临床疗效。

2组患者的围手术期指标（手术时间、术中出血量、术后阴道长度、尿管留置天数）比较差异无统计学意义（t=1.202、1.115、1.650、1.816，P均>0.05）。治疗前2组患者的内分泌因子水平、盆底结构参数比较，差异均无统计学意义（P>0.05）；治疗结束后，试验组的神经肽Y、促卵泡激素水平高于对照组（t=2.107、2.270，P=0.038、0.026），各项盆底结构参数（尿道旋转角、膀胱颈移动度、膀胱后角、肛提肌裂孔前后径、肛提肌裂孔左右径、肛提肌裂孔面积）均低于对照组（t=2.733、2.228、2.221、2.156、2.156、2.977，P均<0.05）。2组患者盆底肌Ⅰ类肌纤维最大电位值、Ⅱ类肌纤维的平均电位值随治疗时间增加而增大，差异有统计学意义，且2组在不同时间点的变化趋势差异有统计学意义（F_时间/P_时间=384.515/<0.001、294.549/<0.001；F_组间/P_组间=0.182/0.670、3.831/0.051；F_交互/P_交互=5.446/0.005、4.604/0.011）。2组患者术前、治疗3个月时盆底肌力比较，差异无统计学意义；治疗结束后，试验组盆底肌力优于对照组（Z=2.471，P<0.05）。2组患者的残余尿量、尿失禁发生频率随治疗时间增加逐渐减少，组间比较差有统计学意义（F_时间/P_时间=2940.820/<0.001、947.226/<0.001；F_组间/P_组间=4.346/0.038、3.999/0.047；F_交互/P_交互=0.299/0.742、0.555/0.575）。治疗前两组患者的尿失禁生活质量问卷评分比较，差异无统计学意义；治疗结束后，试验组患者的尿失禁生活质量问卷评分（包括行为受限、心理影响、社交影响方面）高于对照组（t=2.426、3.047、2.371，P均<0.05）。2组患者治疗总有效率比较，差异无统计学意义（χ²=2.007，P=0.157）。

电刺激生物反馈联合凯格尔运动治疗子宫脱垂的疗效显著，可有效优化盆底肌电值，促进盆底功能恢复，缓解患者临床症状，提高生活质量。

To explore the effect of electrical stimulation biofeedback combined with Kegel exercises on the postoperative rehabilitation of patients with stage II-III uterine prolapse.

This was a retrospective cohort study. The clinical data of 90 patients with uterine prolapse admitted to Wuxi People's Hospital from June 2020 to March 2024 were retrospectively analyzed and the patients were divided into an experimental group (n=46, electrical stimulation biofeedback+Kegel exercise) and a control group (n=44, Kegel exercise) according to different treatment plans. The perioperative indicators, levels of endocrine-related factors, pelvic floor structural parameters, electrophysiological indicators of pelvic floor muscles, pelvic floor muscle strength, urinary function, quality of life scores, and clinical efficacy of the two groups of patients were compared.

There was no statistically significant difference in the perioperative indicators (operation time, intraoperative blood loss, postoperative vaginal length, and indwelling days of urinary catheters between the two groups of patients (t=1.202, 1.115, 1.650, 1.816, P>0.05). Before treatment, there were no statistically significant differences in the levels of endocrine factors and pelvic floor structural parameters between the two groups of patients (P>0.05). After the end of treatment, the levels of neuropeptide Y and follicle-stimulating hormone in the experimental group were higher than those in the control group (t=2.107, 2.270; P=0.038, 0.026). All pelvic floor structural parameters in the experimental group, including the urethral rotation angle, bladder neck mobility, bladder posterior angle, anterior and posterior diameter of anal levator hiatus, left and right diameter of anal levator hiatus, and area of anal levator hiatus, were lower than those in the control group (t=2.733, 2.228, 2.221, 2.156, 2.156, 2.977, P<0.05). The maximum potential value of type Ⅰ pelvic floor muscle fibers and the average potential value of type Ⅱ pelvic floor muscle fibers in both groups increased with prolonged treatment time, with statistically significant differences. Additionally, the differences in the change trends of the two groups at different time points were statistically significant (For type Ⅰ fibers: F_time/P_time=384.515/<0.001; F_group/P_group=0.182/0.670; F_interaction/P_interaction=5.446/0.005; For type Ⅱ fibers: F_time/P_time=294.549/<0.001; F_group/P_group=3.831/0.051; F_interaction/P_interaction=4.604/0.011). There were no statistically significant differences in pelvic floor muscle strength between the two groups of patients before surgery and at 3 months after treatment. After the end of treatment, the pelvic floor muscle strength of the experimental group was superior to that of the control group (Z=2.471, P<0.05).The residual urine volume and urinary incontinence frequency of patients in both groups decreased gradually with the extension of treatment time, and there were statistically significant differences in the inter-group comparison (For residual urine volume: F_time/P_time=2940.820/<0.001; F_group/P_group=4.346/0.038; F_interaction/ P_interaction=0.299/ 0.742; For urinary incontinence frequency: F_time/P_time=947.226/<0.001; F_group/P_group= 3.999/0.047; F_interaction/P_interaction=0.555/0.575). Comparison of the scores of incontinence life quality questionnaire between the two groups of patients before treatment showed no statistically significant difference. After the end of treatment, the scores of incontinence life quality questionnaire in terms of behavioral restriction, psychological impact, and social impact in the experimental group were higher than those in the control group (t=2.426, 3.047, 2.371; P<0.05). There was no statistically significant difference in the comparison of the total effective rate of treatment between the two groups of patients (χ²=2.007, P=0.157).

Electrostimulation biofeedback combined with Kegel exercise is effective in the treatment of uterine prolapse, which can optimize the pelvic floor myoelectric value, promote the pelvic floor function recovery, effectively improve the clinical symptoms of patients and improve the quality of life.