首页资讯盆底功能障碍性疾病诊断及康复治疗专家共识

盆底功能障碍性疾病诊断及康复治疗专家共识

来源：泰然健康网时间：2024年12月18日 22:41

盆底功能障碍性疾病（pelvic floor dysfunction，PFD）是指由盆底支持结构薄弱、缺损及功能障碍等原因引起一系列症状的非器质性疾病，与年龄、肥胖、妊娠分娩、慢性疾病、不良心理刺激等多种因素相关。盆底康复治疗是一种基于多学科循证医学证据的治疗PFD的策略，旨在通过不同的物理治疗措施，激活盆底神经肌肉使盆底肌肉功能逐渐恢复，从而减轻患者盆底功能障碍相关症状，促进盆底康复，提高患者生活质量。目前，PFD的范畴及康复治疗方案相对模糊，为此，江苏省中西医结合学会盆底疾病专业委员会联合上海市医师协会肛肠专业委员会、北京整合医学学会盆底疾病专业委员会、上海市中医药学会肛肠分会，组织国内相关领域专家，以国内外研究成果为依据，结合我国临床实际情况制订本专家共识，以期为PFD规范诊断及康复治疗提供参考。

1 Blomquist JL

Carroll M

Muñoz A

, et al. Pelvic floor muscle strength and the incidence of pelvic floor disorders after vaginal and cesarean delivery[J]. Am J Obstet Gynecol, 2020, 222(1): 62. e1-62.e8.

2 Jundt K

Peschers U

Kentenich H

. The investigation and treatment of female pelvic floor dysfunction[J]. Dtsch Arztebl Int, 2015, 112(33-34):564-574.

中华医学会妇产科学分会妇科盆底学组; 盆腔器官脱垂的中国诊治指南(2020年版)[J]. 中华妇产科杂志, 2020, 55(5): 300-306.

4 Khatri G

Bhosale PR

Robbins JB

, et al. ACR Appropriateness Criteria® pelvic floor dysfunction in females[J]. J Am Coll Radiol, 2022, 19(5S): S137-S155.

5 Quaghebeur J

Petros P

Wyndaele JJ

, et al. Pelvic-floor function, dysfunction, and treatment[J]. Eur J Obstet Gynecol Reprod Biol, 2021, 265: 143-149.

Pelvic floor dysfunction: prevention and non-surgical management[J]. London: National Institute for Health and Care Excellence (NICE); 2021.

中国整形美容协会科技创新与器官整复分会. 女性性功能障碍诊治中国专家共识(2023年版)[J]. 中华妇产科杂志, 2023, 58(9): 641-649.

中华医学会泌尿外科学分会女性泌尿学组. 盆腔器官脱垂伴压力性尿失禁诊断与治疗中国专家共识[J]. 中华泌尿外科杂志, 2023, 44(6): 401-404.

9 Davids JS

Hawkins AT

Bhama AR

, et al. The American Society of colon and rectal surgeons clinical practice guidelines for the management of anal fissures[J]. Dis Colon Rectum, 2023, 66(2): 190-199.

中国医师协会肛肠医师分会; 中国医师协会肛肠医师分会肛肠疾病专家委员会; 中国医师协会肛肠医师分会临床指南工作委员会; 慢性便秘围手术期处理中国专家共识(2021版)[J]. 中华胃肠外科杂志, 2021, 24(12): 1035-1040.

11 Carrington EV

Scott SM

Bharucha A

, et al. Expert consensus document: Advances in the evaluation of anorectal function[J]. Nat Rev Gastroenterol Hepatol, 2018, 15(5): 309-323.

12 Heinrich H

Misselwitz B

. High-resolution anorectal manometry-New insights in the diagnostic assessment of functional anorectal disorders[J]. Visc Med, 2018, 34(2):134-139.

13 Prichard DO

Lee T

Parthasarathy G

, et al. High-resolution anorectal manometry for identifying defecatory disorders and rectal structural abnormalities in women[J]. Clin Gastroenterol Hepatol, 2017, 15(3): 412-420.

张春霞, 金黑鹰, 叶晓瑞, 等. 半卧截石位和左侧卧位对肛肠测压检查的影响与临床意义[J]. 结直肠肛门外科, 2020, 26(4): 464-468.

15 Dietz HP

. Ultrasound in the investigation of pelvic floor disorders[J]. Curr Opin Obstet Gynecol, 2020, 32(6): 431-440.

16 Santoro GA

Wieczorek AP

Stankiewicz A

, et al. High-resolution three-dimensional endovaginal ultrasonography in the assessment of pelvic floor anatomy: a preliminary study[J]. Int Urogynecol J Pelvic Floor Dysfunct, 2009, 20(10):1213-22.

17 van Delft K

Thakar R

Shobeiri SA

, et al. Levator hematoma at the attachment zone as an early marker for levator ani muscle avulsion[J]. Ultrasound Obstet Gynecol, 2014, 43(2): 210-217.

18 Kumar A

Scholefield JH

. Endosonography of the anal canal and rectum[J]. World J Surg, 2000, 24(2): 208-215.

19 Santoro GA

Di Falco G

. Endosonographic anatomy of the normal anal canal[M]//Benign Anorectal Diseases[J]. Milano: Springer Milan, 2006: 35-54.

20 Dobben AC

Terra MP

Slors JF

, et al. External anal sphincter defects in patients with fecal incontinence: comparison of endoanal MR imaging and endoanal US[J]. Radiology, 2007, 242(2): 463-471.

21 Dietz HP

. Pelvic Floor Ultrasound: A Review[J]. Clin Obstet Gynecol, 2017, 60(1): 58-81.

李映, 刘正敏, 谭浩, 等. 排粪造影对出口梗阻病因诊断的临床应用[J]. 中国中西医结合影像学杂志, 2009, 7(5): 365-367.

田宁, 邵广瑞. 动态直肠排粪造影在出口梗阻型便秘中的应用价值(附1055例分析)[J]. 医学影像学杂志, 2018, 28(4): 659-661, 669.

李华山, 王晓锋, 崔国策. 直肠脱垂的盆腔双重与三重造影检查[C].//中华中医药学会肛肠分会第五届理事会换届会议暨全国肛肠学术交流大会论文集. 2011: 636-637.

25 Murad-Regadas SM

Regadas FS

Rodrigues LV

, et al. A novel three-dimensional dynamic anorectal ultrasonography technique (echodefecography) to assess obstructed defecation, a comparison with defecography[J]. Surg Endosc, 2008, 22(4):974-979.

张春霞, 金黑鹰, 杨怡雯,等. 应用BK8838超声探头进行超声排粪造影对盆底疾病的辅助诊断价值分析[J]. 结直肠肛门外科, 2021, 27(2): 137-140.

沈彬艳, 金黑鹰, 张心怡, 等. 超声排粪造影在盆底失弛缓便秘诊断中的价值[J/OL]. 中华临床医师杂志(电子版), 2022, 16(7): 626-629.

28 Regadas FS

Haas EM

Abbas MA

, et al. Prospective multicenter trial comparing echodefecography with defecography in the assessment of anorectal dysfunction in patients with obstructed defecation[J]. Dis Colon Rectum, 2011, 54(6): 686-92.

杨怡雯. 超声排粪造影直肠前突分度及与出口梗阻型便秘临床症候的相关性研究 [D].南京: 南京中医药大学, 2022.

30 Poncelet E

Rock A

Quinton JF

, et al. Dynamic MR defecography of the posterior compartment: Comparison with conventional X-ray defecography[J]. Diagn Interv Imaging, 2017, 98(4): 327-332.

31 van Iersel JJ

Formijne Jonkers HA

Verheijen PM

, et al. Comparison of dynamic magnetic resonance defaecography with rectal contrast and conventional defaecography for posterior pelvic floor compartment prolapse[J]. Colorectal Dis, 2017, 19(1): O46-O53.

32 Kanmaniraja D

Arif-Tiwari H

Palmer SL

, et al. MR defecography review[J]. Abdom Radiol (NY), 2021, 46(4): 1334-1350.

中华医学会放射学分会MR学组. 女性盆底功能障碍性疾病的MRI技术与报告规范[J]. 中华放射学杂志, 2022, 56(1): 16-24.

34 Jiang Y

Kong H

Chang T

, et al. Modified colonic transit test in healthy subjects and constipated patients: A triple-phase, two-center prospective study[J]. J Gastroenterol Hepatol, 2021, 36(4) :959-967.

任晓阳, 殷燕, 闫小妮, 等. 结肠传输试验在评估不同类型便秘患者中的临床应用[J]. 胃肠病学和肝病学杂志, 2021, 30(11): 1277-1281.

36 Xu HM

Han JG

Na Y

, et al. Colonic transit time in patient with slow-transit constipation: comparison of radiopaque markers and barium suspension method[J]. Eur J Radiol, 2011, 79(2): 211-213.

37 Kim ER

Rhee PL

. How to interpret a functional or motility test-colon transit study[J]. J Neurogastroenterol Motil, 2012, 18(1): 94-99.

38 Mc Kertich K

. Urodynamics[J]. Aust Fam Physician, 2011, 40(6): 389-991.

39 Padilla-Fernández B

Ramírez-Castillo GM

Hernández-Hernández D

, et al. Urodynamics before stress urinary incontinence surgery in modern functional urology[J]. Eur Urol Focus, 2019, 5(3): 319-321.

40 van Leijsen SAL

Kluivers KB

Mol BWJ

, et al. Value of urodynamics before stress urinary incontinence surgery: a randomized controlled trial[J]. Obstet Gynecol, 2013, 121(5): 999-1008.

41 Nager CW

Brubaker L

Litman HJ

, et al. A randomized trial of urodynamic testing before stress-incontinence surgery[J]. N Engl J Med, 2012, 366(21): 1987-1997.

42 Kocher NJ

Damaser MS

Gill BC

. Advances in Ambulatory Urodynamics[J]. Curr Urol Rep, 2020, 21(10): 41.

43 Finazzi Agrò E

Bianchi D

Iacovelli V

. Pitfalls in Urodynamics[J]. Eur Urol Focus, 2020, 6(5): 820-822.

44 Sierra T

Sullivan G

Leung K

, et al. The negative predictive value of preoperative urodynamics for stress urinary incontinence following prolapse surgery[J]. Int Urogynecol J, 2019, 30(7): 1119-1124.

45 Baines G

Da Silva AS

Araklitis G

, et al. Recent advances in urodynamics in women[J]. F1000Res, 2020, 9.

46 Chen J

Ren Y

Zhu L

. [Correlation between modified Oxford grading scale and pelvic floor surface electromyography in assessment of pelvic floor muscle function in female patients with stress urinary incontinence][J]. Zhonghua Yi Xue Za Zhi, 2020, 100(37): 2908-2912.

47 Brækken IH

Stuge B

Tveter AT

, et al. Reliability, validity and responsiveness of pelvic floor muscle surface electromyography and manometry[J]. Int Urogynecol J, 2021, 32(12): 3267-3274.

温颖能, 卢秋莲, 王艳. Glazer盆底表面肌电评估产后盆底肌功能康复应用效果[J]. 中国计划生育学杂志, 2023, 31(5): 1105-1109.

易念华, 张艳, 吴兰, 等. Glazer盆底表面肌电评估对产后早期盆底功能恢复的疗效观察[J].中国妇幼保健, 2015, 30(20): 3376-3378.

王莉敏, 王悦. Glazer盆底表面肌电评估对产后早期盆底功能恢复的作用[J]. 微量元素与健康研究, 2021, 38(5): 29-30.

51 Zhang H

Gou Y

Zhang J

, et al. Analysis of pelvic floor electromyography in women screened 42 days postpartum: A cross-sectional study[J]. Medicine (Baltimore), 2023, 102(21): e33851.

OKEAHIALAM NICOLA ADANNA,DWORZYNSKI KATHARINA,

JACKLIN PAUL

,等. 盆底功能障碍的预防和非手术治疗: NICE指南总结[J]. 英国医学杂志中文版,2022,25(9):531-534.

宋晓红, 白文佩, 朱兰, 等. 肥胖女性压力性尿失禁体质量管理中国专家共识(2020版)[J]. 实用临床医药杂志, 2020, 24(2): 1-5.

54 Suares NC

Ford AC

. Systematic review: the effects of fibre in the management of chronic idiopathic constipation[J]. Aliment Pharmacol Ther, 2011, 33(8): 895-901.

55 O'Connor E

Nic An Riogh A

Karavitakis M

, et al. Diagnosis and non-surgical Management of urinary incontinence-A literature review with recommendations for practice[J]. Int J Gen Med, 2021, 14: 4555-4565.

56 Hannestad YS

Rortveit G

Daltveit AK

, et al. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study[J]. BJOG, 2003, 110(3): 247-254.

57 Nazzal Z

Khatib B

Al-Quqa B

, et al. The prevalence and risk factors of urinary incontinence amongst Palestinian women with type 2 diabetes mellitus: A cross-sectional study[J]. Arab J Urol, 2019, 18(1): 34-40.

曹晓明, 马彦杰, 原小斌, 等. 中老年女性2型糖尿病患者膀胱功能障碍与糖尿病病程的相关性研究[J]. 中华泌尿外科杂志, 2017, 38(10): 782-785.

王世言, 孙秀丽. 基于循证研究的女性尿失禁的非手术治疗策略[J]. 实用妇产科杂志, 2022, 38(6): 407-410.

秦丽平, 吴夷, 李函轩, 等. 关于肌电生物反馈仪的检测讨论[J]. 中国医疗器械信息, 2016, 22(13): 53-57.

王永通, 金黑鹰, 肖相楠, 等. 盆底功能障碍性疾病治疗研究进展[J]. 现代医药卫生, 2022, 38(12): 2072-2076.

62 Jung KW

Yang DH

Yoon IJ

, et al. Electrical stimulation therapy in chronic functional constipation: five years’ experience in patients refractory to biofeedback therapy and with rectal hyposensitivity[J]. J Neurogastroenterol Motil, 2013, 19(3): 366-373.

63 Hite M

Curran T

. Biofeedback for Pelvic Floor Disorders[J]. Clin Colon Rectal Surg, 2021, 34(1): 56-61.

64 Skardoon GR

Khera AJ

Emmanuel AV

, et al. Review article: dyssynergic defaecation and biofeedback therapy in the pathophysiology and management of functional constipation[J]. Aliment Pharmacol Ther, 2017, 46(4): 410-423.

65 Thomas GP

Dudding TC

Rahbour G

, et al. Sacral nerve stimulation for constipation[J]. Br J Surg, 2013, 100(2): 174-181.

66 Wang Y

Hassouna MM

. Neuromodulation reduces c-fos gene expression in spinalized rats: a double-blind randomized study[J]. J Urol, 2000, 163(6): 1966-70.

67 Chai TC

Zhang C

Warren JW

, et al. Percutaneous sacral third nerve root neurostimulation improves symptoms and normalizes urinary HB-EGF levels and antiproliferative activity in patients with interstitial cystitis[J]. Urology, 2000, 55(5): 643-646.

68 Fariello JY

Whitmore K

. Sacral neuromodulation stimulation for IC/PBS, chronic pelvic pain, and sexual dysfunction[J]. Int Urogynecol J, 2010, 21(12): 1553-1558.

69 van Kerrebroeck PE

van Voskuilen AC

Heesakkers JP

, et al. Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study[J]. J Urol, 2007, 178(5): 2029-2034.

70 Abrams P

Andersson KE

Birder L

, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence[J]. Neurourol Urodyn, 2010, 29(1): 213-240.

汪司右, 张淑静. 电针阴部神经刺激疗法治疗女性压力性尿失禁的临床疗效和作用机制[J]. 中华泌尿外科杂志, 2013, 34(8): 575-578.

72 Berghmans B

Hendriks E

Bernards A

, et al. Electrical stimulation with non-implanted electrodes for urinary incontinence in men[J]. Cochrane Database Syst Rev, 2013(6): .

73 Lim R

Liong ML

Leong WS

, et al. Patients’ perception and satisfaction with pulsed magnetic stimulation for treatment of female stress urinary incontinence[J]. Int Urogynecol J, 2018, 29(7): 997-1004.

74 Lim R

Liong ML

Leong WS

, et al. Pulsed magnetic stimulation for stress urinary incontinence: 1-year followup results[J]. J Urol, 2017, 197(5): 1302-1308.

75 Bharucha AE

Oblizajek NR

. Translumbosacral neuromodulation therapy is a promising option for fecal incontinence[J]. Am J Gastroenterol, 2021, 116(1): 80-81.

陈舟, 黄和, 陈其余. 补中益气汤加味联合盆底肌肉锻炼-生物反馈-电刺激治疗产后早期盆底功能障碍性疾病的疗效研究[J]. 中国中药杂志, 2018, 43(11): 2391-2395.

王占利, 冯尧伟, 褚玉霞. 褚玉霞教授治疗女性盆底功能障碍性疾病的用药规律研究[J]. 中医研究, 2023, 36(5): 80-85.

缪雪钦, 王红日, 高美云, 等. 金匮肾气丸联合盆底生物反馈治疗肾阳虚型产后压力性尿失禁临床研究[J]. 康复学报, 2021, 31(3): 222-227.

陈惠兰. 益气固脱方加减辅助治疗产后盆底功能障碍性疾病的疗效[J]. 临床医学研究与实践, 2018, 3(26): 111-112.

80 Han W

Wang Y

Qi S

, et al. Observation of the effect of physical rehabilitation therapy combined with the medication on pelvic floor dysfunction[J]. Exp Ther Med, 2018, 15(2): 1211-1216.

周辉, 高湘玲, 黄同森. 针灸联合龙胆泻肝汤对子宫脱垂患者血清TGF-β1、MMP-2、TIMP-2表达的影响[J]. 上海针灸杂志, 2020, 39(1): 37-41.

杨丹丹, 李富成. 举宫汤联合盆底康复治疗盆底功能障碍性疾病的疗效观察[J]. 中国合理用药探索, 2018, 15(1): 14-16.

杜永红. 中药熏洗加穴位贴敷配合keler锻炼治疗妇科盆底功能障碍[J]. 实用妇科内分泌电子杂志, 2016, 3(10): 45, 47.

叶宇飞, 徐慧岩. 四黄祛毒汤保留灌肠联合熏洗治疗功能性肛门直肠痛临床观察[J]. 中华中医药杂志, 2018, 33(3): 1181-1183.

刘薇, 刘仍海, 贾山, 等. 沉香通便膏穴位贴敷治疗结肠慢传输型便秘的临床研究[J]. 中华中医药杂志, 2022, 37(12): 7495-7497.

王晓锋,田雪峰,李华山. 针灸治疗排粪失禁规律分析及研究质量评价[J]. 中华中医药杂志,2019,34(8):3714-3717.

87 Sun Y

Liu Y

Liu S

, et al. Electroacupuncture for women with urgency-predominant mixed urinary incontinence: secondary analysis of a randomized noninferiority trial[J]. World J Urol, 2020, 38(4):1035-1042.

88 Liu Z

Liu Y

Xu H

, et al. Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: A randomized clinical trial[J]. JAMA, 2017, 317(24): 2493-2501.

89 Sun Y

Liu Y

Liu B

, et al. Efficacy of acupuncture for chronic prostatitis/chronic pelvic pain syndrome : A randomized trial[J]. Ann Intern Med, 2021, 174(10): 1357-1366.

彭建民, 高激泳, 邓金梅. 针灸治疗功能性出口梗阻型便秘41例临床观察[J]. 海南医学, 2009, 20(6): 61-62.

程思雨, 高洪娣, 熊国华, 等. 电针八髎穴治疗慢性肛门痛的临床疗效观察[J]. 世界中西医结合杂志, 2021, 16(5): 961-963, 967.

杨香燕, 沙静涛, 杜胜花, 等. 揿针联合生物反馈治疗功能性便秘的疗效及对症状和生活质量的影响[J]. 河北中医, 2021, 43(12): 2063-2066.

黄美霞, 姚祺, 闵羡蕙, 等. 穴位注射治疗经阴道分娩盆底功能障碍的研究[J]. 现代中西医结合杂志, 2014, 23(20): 2167-2169, 2187.

王琳琳, 朱敬云, 任志欣, 等. 电针联合透灸治疗产后盆腔器官脱垂疗效观察[J]. 中国针灸, 2020, 40(2): 157-161.

杨秋晔, 杨义春, 曾燕静, 等. 超声影像学评估产后盆底功能障碍产妇采用艾灸联合盆底肌肉锻炼的效果[J]. 中国性科学, 2021, 30(10): 123-126.

徐丹丹, 辜锐鑫, 周晶, 等. 盆底康复训练结合太极推拿治疗产后压力性尿失禁的临床观察[J]. 时珍国医国药, 2021, 32(6): 1412-1414.

陈峰, 黄如华, 郑玉金, 等. 盆底表面肌电生物反馈联合“认知-协调-建构”的心理干预治疗功能性便秘的临床疗效[J]. 中国老年学杂志, 2017, 37(15): 3798-3800.

张文, 王瑞芳, 荀雷. 知信行干预联合Kegel运动对初产妇产后不良心理及盆底功能恢复的影响[J]. 中国健康心理学杂志, 2022, 30(6): 857-861.

No related articles found!

阅读次数全文

351

HTMLPDF最新录用 在线预览 正式出版最新录用 在线预览 正式出版 0 0 76 0 0 275
来源 本网站其他网站 次数27873 比例79%21%
摘要

2199

来源 本网站其他网站 次数3291870 比例15%85%

盆底功能障碍性疾病诊断及康复治疗专家共识

推荐资讯

从出汗看健康出汗透露你的健康信号

早上怎么喝水最健康？

盆底功能障碍性疾病诊断及康复治疗专家共识

推荐资讯

从出汗看健康 出汗透露你的健康信号

早上怎么喝水最健康？

从出汗看健康出汗透露你的健康信号