【目的】探讨电刺激联合生物反馈训练在产后42 d 产妇盆底康复中的应用。【方法】选取产后42 d 手测盆底肌力小于3级的产妇120例，采用电刺激联合生物反馈治疗，比较不同产次、不同分娩方式治疗前、后盆底Ⅰ类、Ⅱ类肌纤维的肌力。【结...【目的】探讨电刺激联合生物反馈训练在产后42 d 产妇盆底康复中的应用。【方法】选取产后42 d 手测盆底肌力小于3级的产妇120例，采用电刺激联合生物反馈治疗，比较不同产次、不同分娩方式治疗前、后盆底Ⅰ类、Ⅱ类肌纤维的肌力。【结果】剖宫产产后42 d Ⅰ类、Ⅱ类肌纤维肌力显著高于经阴道分娩者（ P ＜0．05）；初产妇的盆底肌力显著高于经产妇（ P ＜0．05）。经电刺激联合生物反馈训练一疗程后，盆底Ⅰ类肌纤维和 Ⅱ类肌纤维肌力均比治疗前增加，差异有统计学意义（ P ＜0．01）。【结论】分娩和妊娠会影响患者的盆底功能，电刺激联合生物反馈训练能显著提高产后妇女的盆底肌力。展开更多
The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecati...The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation. There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation. Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre. Osmotic laxatives may be effective in patients who do not respond to fibre supplements. Stimulant laxatives should be re- served for patients who do not respond to osmotic laxatives. Controlled trials have shown that serotonin- ergic enterokinetic agents, such as prucalopride, and prosecretory agents, such as lubiprostone, are effec- tive in the treatment of patients with chronic constipa- tion. Surgery is sometimes necessary. Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coil who are resistant to medical therapy and who do not have defecatory disorders, generalised motility disorders or psychological disorders. Randomised controlled trials have established the efficacy of rehabilitative treat- ment in dys-synergic defecation. Many surgical proce- dures may be used to treat obstructed defecation in patients with acquired anatomical defects, but none is considered to be the gold standard. Surgery should be reserved for selected patients with an impaired quality of life. Obstructed defecation is often associated with pelvic organ prolapse. Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse, but the efficacy and safety of such procedures have not yet been established.展开更多
Objective To evaluate the effectiveness and safety of the entire pelvic floor reconstruction(Prolift) with uterus reserved in the treatment of pelvic floor dysfunction diseases.Methods From March 2008 to January 2009,...Objective To evaluate the effectiveness and safety of the entire pelvic floor reconstruction(Prolift) with uterus reserved in the treatment of pelvic floor dysfunction diseases.Methods From March 2008 to January 2009,74 female cases from our hospital who had different defects in pelvic organ prolapse were treated with the entire reconstructive pelvic surgery,in which 38 had uterus retained(observation group) and 36 cases had hysterectomy(control group).The two groups were compared.The patients with combined stress urinary incontinence had transobturator tension-free vaginal tape(TVT-O technique) at the same time.The results of operations were objectively evaluatedaccording to Pelvic Organ Prolapse Quantification sub-degree method(POP-Q) developed by the International Continence Society.Results For observation group,the average operative time was 50 min,and the average amount of bleeding was 100 mL.For control group,the average operative time was 110 min,and the average amount of bleeding was 200 mL.During the postoperative follow-up(8 ~18 months),in the observation group the structures of patients' pelvic floor were normal;stress urinary incontinence was all cured;related symptoms disappeared or were markedly improved;and no postoperative infection appeared.In control group,two cases had postoperative infection;the patients ' pelvic structures were normal during the postoperative follow-up;the related symptoms disappeared or were significantly improved.After 3 months,POP-Q score was significantly elevated in the two groups.Conclusion Full reconstructive pelvic surgery with uterus retained can complete the whole pelvic floor structure and function of all or part of the reconstruction with fast recovery and clear short-term effect.However,the long-term efficacy remains to be revealed.展开更多
文摘【目的】探讨电刺激联合生物反馈训练在产后42 d 产妇盆底康复中的应用。【方法】选取产后42 d 手测盆底肌力小于3级的产妇120例，采用电刺激联合生物反馈治疗，比较不同产次、不同分娩方式治疗前、后盆底Ⅰ类、Ⅱ类肌纤维的肌力。【结果】剖宫产产后42 d Ⅰ类、Ⅱ类肌纤维肌力显著高于经阴道分娩者（ P ＜0．05）；初产妇的盆底肌力显著高于经产妇（ P ＜0．05）。经电刺激联合生物反馈训练一疗程后，盆底Ⅰ类肌纤维和 Ⅱ类肌纤维肌力均比治疗前增加，差异有统计学意义（ P ＜0．01）。【结论】分娩和妊娠会影响患者的盆底功能，电刺激联合生物反馈训练能显著提高产后妇女的盆底肌力。
基金Supported by Associazione Italiana Gastroenterologi and Endoscopisti Digestivi Ospedalieri, Via N Colajanni, 4, 00191 Roma, ItalySocietà Italiana di Chirurgia Colo-Rettale, Via Medici, 23, 10143 Torino, Italy
文摘The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation. There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation. Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre. Osmotic laxatives may be effective in patients who do not respond to fibre supplements. Stimulant laxatives should be re- served for patients who do not respond to osmotic laxatives. Controlled trials have shown that serotonin- ergic enterokinetic agents, such as prucalopride, and prosecretory agents, such as lubiprostone, are effec- tive in the treatment of patients with chronic constipa- tion. Surgery is sometimes necessary. Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coil who are resistant to medical therapy and who do not have defecatory disorders, generalised motility disorders or psychological disorders. Randomised controlled trials have established the efficacy of rehabilitative treat- ment in dys-synergic defecation. Many surgical proce- dures may be used to treat obstructed defecation in patients with acquired anatomical defects, but none is considered to be the gold standard. Surgery should be reserved for selected patients with an impaired quality of life. Obstructed defecation is often associated with pelvic organ prolapse. Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse, but the efficacy and safety of such procedures have not yet been established.
文摘Objective To evaluate the effectiveness and safety of the entire pelvic floor reconstruction(Prolift) with uterus reserved in the treatment of pelvic floor dysfunction diseases.Methods From March 2008 to January 2009,74 female cases from our hospital who had different defects in pelvic organ prolapse were treated with the entire reconstructive pelvic surgery,in which 38 had uterus retained(observation group) and 36 cases had hysterectomy(control group).The two groups were compared.The patients with combined stress urinary incontinence had transobturator tension-free vaginal tape(TVT-O technique) at the same time.The results of operations were objectively evaluatedaccording to Pelvic Organ Prolapse Quantification sub-degree method(POP-Q) developed by the International Continence Society.Results For observation group,the average operative time was 50 min,and the average amount of bleeding was 100 mL.For control group,the average operative time was 110 min,and the average amount of bleeding was 200 mL.During the postoperative follow-up(8 ~18 months),in the observation group the structures of patients' pelvic floor were normal;stress urinary incontinence was all cured;related symptoms disappeared or were markedly improved;and no postoperative infection appeared.In control group,two cases had postoperative infection;the patients ' pelvic structures were normal during the postoperative follow-up;the related symptoms disappeared or were significantly improved.After 3 months,POP-Q score was significantly elevated in the two groups.Conclusion Full reconstructive pelvic surgery with uterus retained can complete the whole pelvic floor structure and function of all or part of the reconstruction with fast recovery and clear short-term effect.However,the long-term efficacy remains to be revealed.
