产后阴道压力与阴道表面肌电信号的相关性研究

Correlation between vaginal pressure and vaginal surface EMG in postpartum woman

摘要:

目的 研究产后女性阴道压力与阴道表面肌电信号的相关性，探讨阴道压力检测替代阴道表面肌电信号评估产后盆底功能的可行性。方法 选择1865例产后6～8周的女性，根据有无尿失禁症状，分为SUI组（n=365）和非SUI组（n=1500）。另选择200例盆底功能正常的未生育女性，作为正常未育对照组，分别测量阴道压力值和阴道表面肌电值并比较分析。结果 产后女性的阴道压力值和阴道表面肌电值均低于正常未育女性（P＜0.01）。产后压力性尿失禁（stress urinary incontinence, SUI）的女性阴道压力值和阴道表面值均低于非SUI女性（P＜0.01）。快收缩期和慢收缩期的阴道压力值与阴道表面肌电值均呈强相关性（r1=0.94，r2=0.87，P＜0.01）。根据ROC曲线，阴道压力值与阴道表面肌电值对产后SUI女性均有较好的预测效果，且差异无统计学意义（P＞0.05）。结论 产后女性的阴道压力和盆底肌力均较正常未育女性低，其中SUI女性更为严重。阴道压力值和阴道表面肌电值具有强相关性，阴道压力检测也可作为产后盆底功能初步筛查的方法。

Abstract:

Objective To investigate the relationship between vaginal pressure and surface electromyogram(EMG), and to explore the feasibility of vaginal pressure in assessing postpartum pelvic floor function.Methods Total 1865 postpartum women were enrolled in the study, including 365 cases with stress urinary incontinence(SUI) and 1500 cases without SUI; 200 healthy nulliparous women served as controls. UROSTYM biofeedback electrical stimulator was used to measure the vaginal pressure and the vaginal surface EMG of pelvic floor muscles. Results The vaginal pressure and vaginal surface EMG in postpartum women were lower than those in nulliparous women（P<0.01）. Vaginal pressure and EMG value in SUI women were lower than those in non-SUI women（P<0.01）. The value of vaginal pressure during the fast and slow contraction periods was closed correlated with vaginal EMG（r1=0.94；r2=0.87，P<0.01）. ROC curve showed that both vaginal pressure and EMG had good predicting value for SUI, and there was no significant difference between the two parameters. Conclusion The pelvic floor strength of postpartum women is lower than that of nulliparous women. The vaginal pressure is closely correlated with vaginal surface electromyography, indicating that vaginal pressure may be used to evaluate postpartum pelvic floor function.