Postpartum Pelvic Floor Functional Disorder Of The Early Rehabilitation Period Of Best Choice

Diseases of female pelvic floor dysfunction(female pelvic floor dysfunc-tion,FPFD)is one of the five chronic diseases affecting the quality of human life,including urinary incontinence,fecal incontinence,pelvic organ prolapse,chronic pelvic pain and sexual dysfunction,the domestic information reported incidence may be as high as 25.8%~35.3%.Female pelvic floor dysfunction sexual disease is a multifactorial disease,the pathophysiological mechanism is not fully understood,known risk factors are age,obesity,pregnancy and childbirth,parity,prolonged second stage,reproductive system inflammation,diabetes,nervous system disorders,connective tissue diseases and genetics;Most of these risk factors can make lifestyle changes to human intervention thus lowering the incidence of PFD,but pregnancy and childbirth were almost all women can’t avoid questions epidemiological data indicate that pregnancy and childbirth are independent risk factors for pelvic floor functional disorders;Postpartum FPFD incidence obviously increased,significantly reduced has maternal of life quality;currently large research has confirmed basin end of rehabilitation treatment effect significantly,can effective prevention and treatment basin end of obstacles sex disease,improve women life quality,but so far for rehabilitation treatment best period of research still less;this research through on different period for basin end of rehabilitation treatment postpartum 1 years of effectcompared,to search PFD postpartum early rehabilitation treatment of best period,for PFD of control provides clinical according.Objective To investigate the best period of pelvic floor rehabilitation treatment for postpartum women through comparative and contrastive analysis on the efficacy of rehabilitation treatment performed at different postpartum periods.Subjects and Methods1.object of study478 cases primiparas were selected for routine pelvic floor screening at 42 days after delivery in Henan Maternity and Child Health Hospital from May 2014 to May2015,among which 256 cases were included in treatment group and the other222 cases were in non-treatment group according to personal willingness;based on different treatment time,the treatment group was divided into 42 days treatment group,3 months group and 6 months group;the treatment group was mainly given pelvic floor muscle exercises(Kegel exercise)+ electrical stimulation and biofeedback therapy,while the non-treatment group was only given normal postpartum rehabilitation education;follow-up visit and review were performed 1year later after delivery,and the functional recovery of pelvic floor were compared in200 cases primiparas.2 Methods By detected by specially trained personnel practices + PHENIX U8 through physical rehabilitation therapy instrument(Guangzhou Shanshan companies)to detect pelvic floor muscle function.Treatment group were treated with Pelvic floor muscle rehabilitation system for Pelvic floor muscle rehabilitation,Includes biofeedback electrical stimulation +,30 min each treatment,treatment 2 times a week,10 times for 1courseof treatment,,Ask maternal vaginal rehabilitation athome to do during treatment(vaginal Weights)contraction exercise.while the non-treatment group was only given normal postpartum rehabilitation education,Stressurinary incontinence bywayofquestionnaires completed.3.diagnostic criteria(1)muscle strength : According to the Oxford Pelvic floor muscle strength rating(level 0-5),more than 3 is normal;(2)Pelvic floor muscle fiber fatigue :Pelvic floor Muscles are composed of type I muscle fibers(that is slow twitch fiber which is associated with organ supporting role)and type II muscle fibers(that is fast twitch fiber which closes the urethra When Abdominal pressure increases).Starting point to the highest point 6s end point points between the highest reduction percentage is fatigue,Normal is 0% or a positive value,negative value for an exception.(3)Pelvic floor muscle potential value of the maximum : Scope for 1-30uv;(4)Uterine Prolapse indexing :According to the 8th edition of "obstetrics" pelvic-organ prolapse-score standard score;(5)stress urinary incontinence(SUI)::According to the diagnostic criteria of the International Advisory Committee in 1999 on urinary incontinence diagnosis.4 Statistical methods All the data was putted in Excel,using SPSS21.0 software to import excel,and then carried on the statistical processing.Measurement data were described by mean standard deviation,The statistical analysis of measurement data are using the test,the statistical analysis of counting data are using chi-square test,Statistical significance level was set at 0.05.Count data by chi-squaretest,multiple group comparison P<0.05,the difference was significant.Multiple calibration of the experimental group compared with the same inspection standard=0.01,P<0.01 difference was statistically significant.Multiple calibration test 22 comparison between the experimental group level =0.0167,P<0.0167 difference was statistically significant.Results screening results at 42 days after delivery indicated that there was no statistical significance in the functional differences of puerperal pelvic floor in these 4 groups(P>0.05);re-examination results of follow up visit at 1 year after delivery indicated:pelvic floor muscle strength: there were no statistic significance in comparative differences between 42 days treatment group and 3 months group(P > 0.0167),between 6 months treatment group and non-treatment group(P > 0.01),while the comparative differences in the rest groups were all of statistical significance;fatigue:the therapeutic effects were basically same in 42 days treatment group and 3 months treatment group without statistical significance in differences(P>0.0167);maximum myoelectric potential: the comparative differences between any two groups among these four groups were statistically significant;uterine prolapse and Uracratia: the occurrence rate in 42 days treatment group was obviously lower that in non-treatment group with differences showed statistic significance(P<0.01),while differences in the rest groups were all without statistical significance;Conclusions1.the therapeutic effects reach the best for pelvic floor muscle strength and muscle fiber fatigue if treatment is given within 3 months after delivery;2.while for maximum myoelectric potential,uterine prolapse and stress urinary incontinence,the effects would be best if treatment is given after 42 days since delivery;3.The rehabilitation effects of pelvic floor are remarkable if the treatment is given after 42 days since delivery.Generally speaking,rehabilitation treatment given at the 42 nd day is better than in the 3rd month,in 6th month after delivery and non-treatment.The 42 ndday is the best period for pelvic rehabilitation treatment of unipara,which can effectively improve pelvic floor muscle strength as well as fatigue and lower down the incidence of uterine prolapse and stress urinary incontinence,therefore,it is worthy of clinical application during the treatment of pelvic floor dysfunction disease.