盆底肌康复对预防复杂性外阴阴道假丝酵母菌病及复发性细菌性阴道病复发的疗效研究

发布时间：2018-03-09 14:38

  本文选题：盆腔器官脱垂　切入点：盆底肌康复　出处：《中国实用妇科与产科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨仿生物电刺激技术、生物反馈及Kegel锻炼等康复技术对盆底肌肉功能恢复及改善盆腔营养的作用及其对复杂性外阴阴道假丝酵母菌病(RVVC)和复发性细菌性阴道病(RBV)的治疗效果。方法选择2014年1月至2015年7月淮安市妇幼保健院121例RVVC和RBV病例,随机分为对照组和观察组。对照组,RVVC:咪康唑栓剂阴道给药,1粒/晚,共7~14 d,首次口服氟康唑150 mg,72 h加服1次;维持治疗药物:克霉唑栓剂或氟康唑1次/周,连用6个月或者伊曲康唑400 mg,1次/月或100 mg,1次/周,共6个月;根据检查结果选择其中1种。RBV:甲硝唑、替硝唑或克林霉素口服,甲硝唑栓阴道用药,每晚1次,或2%克林霉素软膏涂擦,共7 d。观察组在阴道炎症非急性期给予盆底仿生物电刺激、生物反馈和Kegel锻炼。观察经盆底康复治疗1年内阴道炎复发的情况。结果盆底肌功能治疗前Ⅰ类肌肌力4、5级者4例,Ⅱ类肌肌力4、5级者8例;治疗后Ⅰ类肌肌力达4、5级者59例,Ⅱ类肌肌力达4、5级者60例(P0.001);治疗前阴道前壁脱垂53例,治疗后阴道前壁脱垂49例(P=0.328),治疗前阴道后壁脱垂25例,治疗后阴道前壁脱垂11例(P=0.005),治疗前子宫脱垂14例,治疗后子宫脱垂2例(P=0.002);与单纯药物治疗相比较盆底康复治疗后随访1年阴道炎复发率显著降低,61例阴道炎患者,治疗后只有2例复发(P0.05)。结论盆底康复治疗明显提高盆底功能,显著恢复妊娠和分娩对阴道结构造成的松弛和脱垂。与单纯药物治疗相比,盆底康复治疗明显降低RVVC和RBV复发率。
[Abstract]:Objective to explore the technique of bioelectric stimulation, Effects of biofeedback and Kegel exercise on the recovery of pelvic floor muscle function and improvement of pelvic nutrition and its therapeutic effect on complex vulvovaginal candidiasis and recurrent bacterial vaginosis. From January 2014 to July 2015, there were 121 cases of RVVC and RBV in Huaian Maternal and Child Health Hospital. The control group was randomly divided into control group and observation group. The control group RVVC: miconazole suppository vaginal administration 1 capsule per night, a total of 7 days, the first oral fluconazole 150 mg / 72 h plus once a week, maintain the treatment drug: clotrimazole suppository or fluconazole once a week, the first time oral fluconazole 150 mg / 72 h, maintenance drug: clotrimazole suppository or fluconazole once a week, One type of RBV was selected according to the examination results: metronidazole, tinidazole or clindamycin, metronidazole, tinidazole or clindamycin, metronidazole suppository vaginal medication once a night, Or 2% clindamycin ointment for 7 days. Biofeedback and Kegel exercise. The recurrence of vaginitis within one year after pelvic floor rehabilitation was observed. Results before pelvic floor function therapy, there were 4 cases of class 鈪，

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