Observation on the efficacy of biofeedback electrical stimulation combined with insulin detemir injection and Kegel training in the treat-ment of postpartum pelvic floor dysfunction in patients with gestational diabetes mellitus
Observation on the efficacy of biofeedback electrical stimulation combined with insulin detemir injection and Kegel training in the treat-ment of postpartum pelvic floor dysfunction in patients with gestational diabetes mellitus
Objective To investigate the clinical efficacy of biofeedback electrical stimulation combined with insulin detemir injection and Kegel training in the treatment of patients with gestational diabetes mellitus and pelvic floor dysfunction.Methods A total of 124 patients with postpartum pelvic floor dysfunction caused by gestational diabetes mellitus admitted to the Department of Obstetrics,Tangshan Maternal and Child Health Hospital from June 2021 to January 2023 were prospectively included in the study.According to the random number table method,the pa-tients were divided into the control group and the experimental group,with 62 cases in each group.The control group was given insulin injection combined with Kegel training intervention,and the experimental group was given biofeedback electrical stimulation intervention based on the con-trol group.The intervention lasted for 3 months.After intervention,the clinical efficacy,perineal muscle strength assessment grading(≥gradeⅢ,≤grade Ⅱ),type Ⅰ and type Ⅱ muscle fiber strength were compared between the two groups.The fatigue of pelvic floor muscle fibers and the pelvic organ prolapse symptom scale(POP-SS)score were compared before intervention and 1 and 3 months after intervention.At the same time,ultrasound findings of pelvic floor structure[levator hiatus(LHS),levator-urethra gap(LUG),and the thickness of the levator ani mus-cle]were evaluated.In addition,homeostasis model assessment insulin resistance index(HOMA-IR)and β cell function assessment(HOMA-β)were monitored after the intervention.Results After intervention,the total effective rate of the experimental group was 98.39％,which was higher than that of the control group(82.26％),and the difference was statistically significant(P＜0.05).The proportion of patients with peri-neal muscle strength assessment grade≥ Ⅲ in the experimental group was 96.77％,which was higher than that in the control group(72.58％),the muscle strength of type Ⅰ and type Ⅱ muscle fibers in the experimental group were(8.14±1.36)and(9.56±1.69)μV,respectively,which were higher than those in the control group[(5.45±1.58),(7.05±1.15)μV],and the differences were statistically significant(P＜0.05).After 1 and 3 months of intervention,the fatigue degree of type Ⅰ and type Ⅱ muscle fibers in the two groups was lower than that before intervention,and the fatigue degree of type Ⅰ and type Ⅱ muscle fibers in the experimental group was lower than that in the control group,the differences were statistically significant(P＜0.05).After 1 and 3 months of intervention,the POP-SS scores of the two groups were lower than those before intervention,and the POP-SS score of the experimental group was significantly lower than that of the control group,the differences were statistically significant(P＜0.05).After 3 months of intervention,the LUG of the control group was lower than that before the intervention,the LHS and LUG of the experimental group were lower than those before the intervention,the thickness of the levator ani muscle of the two groups was higher than that before the intervention,and the LHS and LUG of the experimental group were significantly lower than those of the control group,the thickness of the levator ani muscle was significantly higher than that of the control group,the differences were statistically significant(P＜0.05).After 3 months of intervention,the HOMA-IR of the two groups was lower than that before intervention,and the HOMA-β was higher than that before intervention.The HOMA-IR of the experimental group was 4.69±0.71,which was lower than that of the control group(4.98±0.63),and the HOMA-β was 179.36±11.17,which was higher than that of the control group(160.18±11.35),the differences were statistically significant(P＜0.05).Conclusion The comprehensive treatment of biofeedback electrical stimulation combined with insulin detemir injection and Kegel training for patients with postpartum pelvic floor dysfunction in gestational diabetes mellitus is reliable.It can signifi-cantly improve perineal muscle strength and muscle fiber strength,reduce fatigue,and improve pelvic organ prolapse symptoms and glucose metab-olism related indicators.It has good clinical application value.
维普
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