近10年国内外盆底康复的可视化分析

doi:10.3969/j.issn.1006-9771.2023.06.007

摘要/Abstract

摘要：

目的对国内外盆底康复领域相关文献进行可视化分析，归纳总结目前盆底功能障碍(PFD)研究的热点和前沿。
方法检索并筛选CNKI和Web of Science数据库2012年1月至2022年6月与PFD康复相关文献，采用CiteSpace软件对发文趋势、作者、机构、关键词等进行可视化分析。
结果共纳入文献2 448篇。国内高质量研究文献发表相对较少。研究热点方面，国内外均关注PFD原因、机制、康复技术和评价指标等的研究，但国内研究对PFD的评价指标以及预防普及方面关注度不足。2022年持续出现的关键词为怀孕造成PFD的机制、前列腺癌患者术后并发症治疗、盆底肌肉训练的作用和女性生活质量研究，可能为未来研究热点和趋势。
结论盆底康复领域相关研究呈上升趋势。未来我国仍存在较大的发展空间。

关键词: 盆底功能障碍, 康复, 可视化分析

Abstract:

Objective To perform a visualized analysis on the relevant literature about rehabilitation in pelvic floor dysfunction (PFD) domestic and abroad, and summarize the current hot spots and frontiers in this field.
Methods The literature related to PFD rehabilitation from January, 2012 to June, 2022 was searched and screened from the databases of CNKI and Web of Science, and the CiteSpace software was used to analyze the trends of publications, authors, institutions and key words.
Results A total of 2 448 articles were included. Relatively few high-quality domestic researches were published. In terms of research hotspots, both domestic and international researches focused on causes, mechanisms, rehabilitation techniques and evaluation indicators of PFD, but domestic researches had not paid enough attention to evaluation indicators and prevention of PFD. The key words constantly appeared in 2022 were mechanisms of PFD due to pregnancy, treatment of postoperative complications in prostate cancer patients, the role of pelvic floor muscle training, and quality of life studies in women.
Conclusion Research related to the field of PFD rehabilitation is increasing. There is still a large gap for future development in China.

Key words: pelvic floor dysfunction, rehabilitation, visualized analysis

中图分类号:

R694

吴千豪, 侯榕洁, 傅丽媛. 近10年国内外盆底康复的可视化分析[J]. 《中国康复理论与实践》, 2023, 29(6): 673-685.

WU Qianhao, HOU Rongjie, FU Liyuan. Pelvic floor rehabilitation domestic and abroad in the last decade: a visualized analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 673-685.

图/表 9

图1

图2

图3

图4

图5

图6

表1

图7

表2

女性PFD康复理论架构分析表"

疾病健康分类(ICD-11)	功能/障碍/健康-影响(ICF)			健康干预措施(ICHI)			效果指标和评价
疾病健康分类(ICD-11)	结构^[25]	功能^[25]	其他健康影响^[26-27]	证据水平	等级	干预措施	临床评价指标	生活质量指标
尿失禁^[28-29] (MF50.2)	s199 神经系统的结构，未特指 s6102 膀胱 s7402 骨盆部肌肉 s7403 骨盆部韧带和筋膜	b620 排尿功能 b630 与泌尿功能相关的感觉 b640 性功能 b730 肌肉力量功能 b735 肌张力功能 b740 肌肉耐力功能	生活质量人际交往和人际关系经济生活情感功能	Ⅰ	A	1.PFMT联合 ①具有监督作用：集体训练、个人培训 ②心理干预 ③行为干预 ④理疗：电刺激、生物反馈 (肌电、超声) ⑤训练方法或用具：阴道椎、低压力训练、全身振动、阴道内振动 2.行为干预-改变生活方式减重、饮食(咖啡因摄入量)、运动	1. 国际尿失禁咨询问卷简表 2.布垫试验 3. 尿失禁生活质量问卷 4.失禁问卷简版 5.泌尿生殖影响量表-简版6 6.超声检查	1.36项健康调查简表 2.King健康问卷 3.情感功能类量表：抑郁自评量表、焦虑自评量表 4.大便失禁的生活质量量表(大便失禁专用)
				Ⅱa	B	单独使用：电刺激或生物反馈(肌电、超声)或阴道椎
				Ⅱb	C	手法治疗：针灸、触发点治疗、按摩
				新型干预措施		磁刺激
盆腔器官脱垂^{[30⇓⇓-33]}(GC40)	s5400 小肠 s5401 大肠 s6102 膀胱 s6103 尿道 s6301 子宫的结构 s7402 骨盆部肌肉 s7403 骨盆部韧带和筋膜	b525 排便功能 b620 排尿功能 b630 与泌尿功能相关的感觉 b640 性功能 b670 与生殖和生育功能相关的感觉 b730 肌肉力量功能 b735 肌张力功能 b740 肌肉耐力功能		Ⅰ	A	PFMT联合生物反馈(肌电、超声)	1.盆腔器官脱垂定量评分 2.盆腔器官脱垂症状评分 3.盆底功能障碍问卷-20 4.盆底功能影响问卷-简表7
				Ⅱa	B	1.子宫托 2.理疗：电刺激、磁刺激等联合生物反馈治疗 3.生活方式干预、药物治疗、振动训练
				Ⅱb	C	1.单独PFMT 2.子宫托：有生育需求使用
						手术治疗
大便失禁^[34⇓-36](ME07)	s199 神经系统的结构，未特指 s7402 骨盆部肌肉	b525 排便功能 b730 肌肉力量功能 b735 肌张力功能 b740 肌肉耐力功能		Ⅰ	A	生活方式调整：减重、戒烟	1.大便失禁严重指数 2.肛门直肠生理测试 3.球囊排出试验 4.腔内超声/盆底MRI检查 5.圣马克大便失禁评分 6.钡-排粪造影
				Ⅱa	A	1.PFMT联合生物反馈 2.行为疗法：排便训练等、饮食建议
				Ⅱb	B	1.经皮胫骨后神经刺激 2.肛塞
						手术治疗
				新型干预措施		骶神经调节、针灸、膨胀性植入物、激素治疗
膀胱过度活动症^[37⇓-39] (GC50.0)	s199 神经系统的结构，未特指 s6102 膀胱 s7402 骨盆部肌肉	b630 与泌尿功能相关的感觉 b640 性功能 b730 肌肉力量功能 b735 肌张力功能 b740 肌肉耐力功能		Ⅰ	A	行为干预(饮食、戒烟戒酒、减重等)联合膀胱训练或PFMT辅助分散注意力训练	1.排尿记录 2.膀胱过度活动症症状评分量表 3.改良牛津肌力分级评估
				Ⅱa	B	药物治疗
				Ⅱb	C	1.骶神经刺激 2.胫骨后神经刺激
与外阴、阴道或盆底有关的疼痛^[40-41] (GA34.0)	s199 神经系统的结构，未特指 s620 骨盆的结构 s6301 子宫的结构 s6303 阴道和外生殖器的结构 s6309 生殖系统的结构，未特指	b525 排便功能 b620 排尿功能 b630 与泌尿功能相关的感觉 b640 性功能 b670 与生殖和生育功能相关的感觉 b730 肌肉力量功能 b735 肌张力功能 b740 肌肉耐力功能		Ⅱa	B	1.物理治疗：组织按摩和肌筋膜松解、手法治疗、电刺激、盆底训练、生物反馈疗法、膀胱和肠道训练、盆底肌肉伸展 2.心理干预、认知行为疗法(与药物和物理疗法联合使用) 3.性疗法：单独或联合物理治疗、认知行为疗法 4.药物治疗、触发点注射	1.指南中无金标准 2.专家共识：盆腔疼痛评估表、经阴道超声和MRI 3.美国精神病学会精神病诊断统计手册(DSM)-5诊断标准
						手术治疗
				新型干预措施		针灸和瑜伽治疗

表2

参考文献 79

[1]	FLUSBERG M, KOBI M, BAHRAMI S, et al. Multimodality imaging of pelvic floor anatomy[J]. Abdom Radiol (NY), 2021, 46(4): 1302-1311.
[2]	KATO M K, MURO S, KATO T, et al. Spatial distribution of smooth muscle tissue in the female pelvic floor and surrounding the urethra and vagina[J]. Anat Sci Int, 2020, 95(4): 516-522. doi: 10.1007/s12565-020-00549-9 pmid: 32419067
[3]	MEEKINS A R, SIDDIQUI N Y. Diagnosis and management of postpartum pelvic floor disorders[J]. Obstet Gynecol Clin North Am, 2020, 47(3): 477-486. doi: 10.1016/j.ogc.2020.05.002
[4]	ARNOUK A, DE E, REHFUSS A, et al. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders[J]. Curr Urol Rep, 2017, 18(6): 47. doi: 10.1007/s11934-017-0694-7 pmid: 28585105
[5]	赵玉娇, 崔璨, 沈文, 等. 基于盆底解剖学的经阴道分娩损伤与评估[J]. 中国临床解剖学杂志, 2017, 35(1): 112-113, 116.
	ZHAO Y J, CUI C, SHEN W, et al. Assessments and types of vaginal delivery injury based on the pelvic floor anatomy[J]. Chin J Clin Anat, 2017, 35(1): 112-113, 116.
[6]	XU Z, HE H, YU B, et al. Application of transperineal pelvic floor ultrasound in changes of pelvic floor structure and function between pregnant and non-pregnant women[J]. Int J Womens Health, 2022, 14: 1149-1159. doi: 10.2147/IJWH.S361755 pmid: 36046177
[7]	KAMISAN ATAN I, ZHANG W, SHEK K L, et al. Does pregnancy affect pelvic floor functional anatomy? A retrospective study[J]. Eur J Obstet Gynecol Reprod Biol, 2021, 259: 26-31. doi: 10.1016/j.ejogrb.2021.01.047 pmid: 33561585
[8]	TRUTNOVSKY G, GUZMAN-ROJAS R, MARTIN A, et al. Pelvic floor dysfunction: Does menopause duration matter?[J]. Maturitas, 2013, 76(2): 134-138. doi: 10.1016/j.maturitas.2013.06.012
[9]	ZHUO Z, WANG C, YU H, et al. The relationship between pelvic floor function and sexual function in perimenopausal women[J]. Sex Med, 2021, 9(6): 100441.
[10]	PAN J, LIANG E, CAI Q, et al. Progress in studies on pathological changes and future treatment strategies of obesity-associated female stress urinary incontinence: a narrative review[J]. Transl Androl Urol, 2021, 10(1): 494-503. doi: 10.21037/tau-20-1217 pmid: 33532337
[11]	范国荣, 薄海欣, 陈洁, 等. 盆底功能障碍性疾病"一体化管理体系"的构建[J]. 中国实用护理杂志, 2019, 35(10): 764-768.
	FAN G R, BO H X, CHEN J, et al. Construction of "Integrated Management System" for pelvic floor dysfunction[J]. Chin J Prac Nurs, 2019, 35(10): 764-768.
[12]	RIEGER M, DURAN P, COOK M, et al. Quantifying the effects of aging on morphological and cellular properties of human female pelvic floor muscles[J]. Ann Biomed Eng, 2021, 49(8): 1836-1847. doi: 10.1007/s10439-021-02748-5 pmid: 33683527
[13]	陈鑫, 刘志梅, 王玉杰, 等. 产后尿失禁患者心理体验的质性研究[J]. 护理学杂志, 2021, 36(22): 77-79.
	CHEN X, LIU Z M, WANG Y J, et al. A qualitative study on lived experience of postpartum women with urinary incontinenc[J]. J Nurs Sci, 2021, 36(22): 77-79.
[14]	CACCIARI L P, MORIN M, MAYRAND M H, et al. Never too late to train: the effects of pelvic floor muscle training on the shape of the levator hiatus in incontinent older women[J]. Int J Environ Res Public Health, 2022, 19(17): 11078. doi: 10.3390/ijerph191711078
[15]	DUMOULIN C, CACCIARI L P, HAY-SMITH E J C. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women[J]. Cochrane Database Syst Rev, 2018, 10(10): CD005654.
[16]	BØ K, HILDE G, STÆR-JENSEN J, et al. Postpartum pelvic floor muscle training and pelvic organ prolapse: a randomized trial of primiparous women[J]. Am J Obstet Gynecol, 2015, 212(1): 38.e1-e7. doi: 10.1016/j.ajog.2014.06.049
[17]	MØRKVED S, BØ K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review[J]. Br J Sports Med, 2014, 48(4): 299-310. doi: 10.1136/bjsports-2012-091758
[18]	HAGEN S, ELDERS A, STRATTON S, et al. Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial[J]. BMJ, 2020, 371: m3719.
[19]	HAY-SMITH J, DEAN S, BURGIO K, et al. Pelvic-floor-muscle-training adherence "modifiers": a review of primary qualitative studies: 2011 ICS State-of-the-Science Seminar Research Paper III of IV[J]. Neurourol Urodyn, 2015, 34(7): 622-631. doi: 10.1002/nau.22771
[20]	ZHONG D, LUO S, ZHENG L, et al. Epilepsy occurrence and circadian rhythm: a bibliometrics study and visualization analysis via CiteSpace[J]. Front Neurol, 2020, 11: 984. doi: 10.3389/fneur.2020.00984 pmid: 33250835
[21]	ZANG X M, ZHU Y Y, ZHONG Y G, et al. CiteSpace-based bibliometric review of pickup and delivery problem from 1995 to 2021[J]. Appl Sci, 2022, 12(9): 4607. doi: 10.3390/app12094607
[22]	邱卓英, 李伦, 陈迪, 等. 基于世界卫生组织国际健康分类家族康复指南研究:理论架构和方法体系[J]. 中国康复理论与实践, 2020, 26(2): 125-135. doi: 10.3969/j.issn.1006-9771.2020.02.001
	QIU Z Y, LI L, CHEN D, et al. Research on rehabilitation guidelines using World Health Organization Family International Classifications: framework and approaches[J]. Chin J Rehabil Theory Pract, 2020, 26(2): 125-135.
[23]	OKEAHIALAM N A, DWORZYNSKI K, JACKLIN P, et al.; Guideline Committee. Prevention and non-surgical management of pelvic floor dysfunction: summary of NICE guidance[J]. BMJ, 2022, 376: n3049.
[24]	National Institute for Health and Clinical Excellence. Pelvic floor dysfunction: prevention and non-surgical management[M]. London: National Institute for Health and Clinical Excellence (NICE), 2021.
[25]	邱卓英, 张爱民. «国际功能、残疾和健康分类»应用指导(一)[J]. 中国康复理论与实践, 2003, 9(1): 25-39.
[26]	邱卓英. «国际功能、残疾和健康分类»应用指导(二)[J]. 中国康复理论与实践, 2003, 9(2): 47-54.
[27]	邱卓英. «国际功能、残疾和健康分类»应用指导(三)[J]. 中国康复理论与实践, 2003, 9(3): 47-51.
[28]	罗德毅, 沈宏. 女性尿失禁的诊断与鉴别诊断[J]. 中国实用妇科与产科杂志, 2017, 33(10): 1002-1005. doi: 10.19538/j.fk2017100104
	LUO D Y, SHEN H. Diagnosis and differential diagnosis of female urinary incontinence[J]. Chin J Pract Gynecol Obstetr, 2017, 33(10): 1002-1005.
[29]	MAZUR-BIALY A I, KOŁOMAŃSKA-BOGUCKA D, NOWAKOWSKI C, et al. Urinary incontinence in women: modern methods of physiotherapy as a support for surgical treatment or independent therapy[J]. J Clin Med, 2020, 9(4): 1211. doi: 10.3390/jcm9041211
[30]	刘丹, 夏志军. 美国妇产科医师学会"盆腔器官脱垂临床实践指南(2017版)"解读[J]. 中国实用妇科与产科杂志, 2018, 34(10): 1111-1114. doi: 10.19538/j.fk2018100111
	LIU D, XIA Z J. American College of Obstetricians and Gynecologists "Clinical Practice Guidelines for Pelvic Organ Prolapse (2017 edition)[J]. Chin J Pract Gynecol Obstetr, 2018, 34(10): 1111-1114.
[31]	WANG T, WEN Z, LI M. The effect of pelvic floor muscle training for women with pelvic organ prolapse: a meta-analysis[J]. Int Urogynecol J, 2022, 33(7): 1789-1801. doi: 10.1007/s00192-022-05139-z
[32]	TSO C, LEE W, AUSTIN-KETCH T, et al. Nonsurgical treatment options for women with pelvic organ prolapse[J]. Nurs Womens Health, 2018, 22(3): 228-239. doi: 10.1016/j.nwh.2018.03.007
[33]	FLEISCHER K, THIAGAMOORTHY G. Pelvic organ prolapse management[J]. Post Reproductive Health, 2020, 26(2): 79-85. doi: 10.1177/2053369120937594 pmid: 32627701
[34]	ASSMANN S L, KESZTHELYI D, KLEIJNEN J, et al. Guideline for the diagnosis and treatment of Faecal Incontinence: a UEG/ ESCP/ ESNM/ ESPCG collaboration[J]. UE Gastroenterol J, 2022, 10(3): 251-286.
[35]	丁曙晴, 周惠芬, 丁义江. 美国结直肠外科医师协会临床实践指南:大便失禁的治疗[J]. 中华消化外科杂志, 2015, 14(10): 800-805.
	DING S Q, ZHOU H F, DING Y J. American Association of Colorectal Surgeons Clinical Practice Guidelines: treatment of fecal incontinence[J]. Chin J Dig Surg, 2015, 14(10): 800-805.
[36]	WALD A. Diagnosis and management of fecal incontinence[J]. Curr Gastroenterol Rep, 2018, 20(3): 9. doi: 10.1007/s11894-018-0614-0 pmid: 29582182
[37]	RAJU R, LINDER B J. Evaluation and treatment of overactive bladder in women[J]. Mayo Clin Proc, 2020, 95(2): 370-377. doi: S0025-6196(19)31039-0 pmid: 32029089
[38]	LERON E, WEINTRAUB A Y, MASTROLIA S A, et al. Overactive bladder syndrome: evaluation and management[J]. Curr Urol, 2018, 11(3): 117-125. doi: 10.1159/000447205
[39]	BRUCKER B M, LEE R K, NEWMAN D K. Optimizing nonsurgical treatments of overactive bladder in the United States[J]. Urology, 2020, 145: 52-59. doi: 10.1016/j.urology.2020.06.017 pmid: 32598892
[40]	王健, 张师前, 刘玉光, 等. 女性慢性盆腔疼痛临床管理的专家共识(2021年版)[J]. 北京医学, 2021, 43(7): 650-659.
	WANG J, ZHANG S Q, LIU Y G, et al. Expert Consensus on the Clinical Management of Chronic Pelvic Pain in Women (2021 Edition)[J]. Beijing Med J, 2021, 43(7): 650-659.
[41]	VINCENT K, EVANS E. An update on the management of chronic pelvic pain in women[J]. Anaesthesia, 2021, 76(Suppl 4): 96-107. doi: 10.1111/anae.v76.s4
[42]	FREEMAN A, MENEES S. Fecal Incontinence and pelvic floor dysfunction in women: a review[J]. Gastroenterol Clin North Am, 2016, 45(2): 217-237. doi: 10.1016/j.gtc.2016.02.002
[43]	ALAPATI S, JAMBHEKAR K. Dynamic magnetic resonance imaging of the pelvic floor[J]. Semin Ultrasound CT MR, 2017, 38(3): 188-199. doi: S0887-2171(16)30097-X pmid: 28705367
[44]	QUAGHEBEUR J, PETROS P, WYNDAELE J J, et al. Pelvic-floor function, dysfunction, and treatment[J]. Eur J Obstet Gynecol Reprod Biol, 2021, 265: 143-149. doi: 10.1016/j.ejogrb.2021.08.026 pmid: 34492609
[45]	YAO H, SUN P, ZHANG J, et al. Efficacy of pelvic floor reconstruction combined with pelvic floor rehabilitation instrument on MMP-7, TIMP-1 and pelvic floor dysfunction in women[J]. Int J Clin Exper Med, 2018, 11(5): 4771-4778.
[46]	LÚCIO A, LOURENÇO C B, DAMASCENO B P, et al. The effect of pelvic floor muscle contraction on detrusor overactivity pressure in neurogenic and nonneurogenic women during urodynamic study: a cross-sectional study[J]. Am J Phys Med Rehabil, 2019, 98(4): 275-279. doi: 10.1097/PHM.0000000000001065
[47]	PIERCE H, PERRY L, CHIARELLI P, et al. A systematic review of prevalence and impact of symptoms of pelvic floor dysfunction in identified workforce groups[J]. J Adv Nurs, 2016, 72(8): 1718-1734. doi: 10.1111/jan.12909 pmid: 26887537
[48]	BEJI N K, SATIR G, AYIR G. Effect of pregnancy process on urinary system and pelvic floor and nursing approach[J]. Bezmialem Sci, 2020, 8(2): 206-211. doi: 10.14235/bs.
[49]	BOZKURT M, YUMRU A E, ŞAHIN L. Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor[J]. Taiwan J Obstet Gynecol, 2014, 53(4): 452-458. doi: 10.1016/j.tjog.2014.08.001 pmid: 25510682
[50]	JOU I M, LAI K A, SHEN C L, et al. Changes in conduction, blood flow, histology, and neurological status following acute nerve-stretch injury induced by femoral lengthening[J]. J Orthop Res, 2000, 18(1): 149-155. pmid: 10716291
[51]	YOUSSEF A, BRUNELLI E, PILU G, et al. The maternal pelvic floor and labor outcome[J]. Am J Obstet Gynecol MFM, 2021, 3(6S): 100452. doi: 10.1016/j.ajogmf.2021.100452
[52]	李然. 不同分娩方式对产后盆底功能影响的对比分析[J]. 中外医学研究, 2022, 20(8): 130-133.
	LI R. Comparative analysis of the effects of different delivery methods on postpartum pelvic floor function[J]. Chin Foreign Med Res, 2022, 20(8): 130-133.
[53]	DE ARAUJO C C, COELHO S A, STAHLSCHMIDT P, et al. Does vaginal delivery cause more damage to the pelvic floor than cesarean section as determined by 3D ultrasound evaluation? A systematic review[J]. Int Urogynecol J, 2018, 29(5): 639-645. doi: 10.1007/s00192-018-3609-3 pmid: 29564512
[54]	罗汝秀, 李娇蓉, 王乐丹, 等. 妊娠中晚期孕妇盆底功能障碍性疾病发生情况及影响因素分析[J]. 中国乡村医药, 2021, 28(22): 3-4.
	LUO R X, LI J R, WANG L D, et al. Incidence and influencing factors of pelvic floor dysfunction in second and third trimesters of pregnancy[J]. Chin J Rural Med Pharm, 2021, 28(22): 3-4.
[55]	SCARABELOT K S, ANTUNES M M U, PELEGRINI A, et al. Pelvic, anorectal and urinary symptoms according to the nutritional status of adult women: a cross-sectional study[J]. Revista de Nutrição, 2019, 32: UNSP e180257.
[56]	MUNGOVAN S F, CARLSSON S V, GASS G C, et al. Preoperative exercise interventions to optimize continence outcomes following radical prostatectomy[J]. Nat Rev Urol, 2021, 18(5): 259-281. doi: 10.1038/s41585-021-00445-5 pmid: 33833445
[57]	CANNING A, RAISON N, AYDIN A, et al. A systematic review of treatment options for post-prostatectomy incontinence[J]. World J Urol, 2022, 40(11): 2617-2626. doi: 10.1007/s00345-022-04146-5 pmid: 36107210
[58]	KADONO Y, NOHARA T, KAWAGUCHI S, et al. Impact of pelvic anatomical changes caused by radical prostatectomy[J]. Cancers (Basel), 2022, 14(13): 3050. doi: 10.3390/cancers14133050
[59]	RAHNAMA'I M S, MARCELISSEN T, GEAVLETE B, et al. Current management of post-radical prostatectomy urinary incontinence[J]. Front Surg, 2021, 8: 647656. doi: 10.3389/fsurg.2021.647656
[60]	SHENG Y, CARPENTER J S, ASHTON-MILLER J A, et al. Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review[J]. BMC Womens Health, 2022, 22(1): 161. doi: 10.1186/s12905-022-01742-w pmid: 35562699
[61]	蔡文智, 张焱, 陈玲, 等. 电刺激联合生物反馈治疗初产妇和经产妇压力性尿失禁的疗效观察[J]. 中国康复医学杂志, 2020, 35(2): 141-145, 150.
	CAI W Z, ZHANG Y, CHEN L, et al. Therapeutic effect of electric stimulation combined with biofeedback on primipara and multipara with stress urinary incontinence[J]. Chin J Rehabil Med, 2020, 35(2): 141-145, 150.
[62]	HITE M, CURRAN T. Biofeedback for pelvic floor disorders[J]. Clin Colon Rectal Surg, 2021, 34(1): 56-61. doi: 10.1055/s-0040-1714287
[63]	全晓洁, 常小霞, 沈玮, 等. 电刺激联合生物反馈疗法对女性压力性尿失禁生活质量影响研究[J]. 中国实用妇科与产科杂志, 2021, 37(10): 1066-1069.
	QUAN X J, CHANG X X, SHEN W, et al. Effect of the treatment of electric stimulation combined with biofeedback on the life quality of women with stress urinary incontinence[J]. Chin J Pract Gynecol Obstetrics, 2021, 37(10): 1066-1069.
[64]	LEONARDO K, SENO D H, MIRZA H, et al. Biofeedback-assisted pelvic floor muscle training and pelvic electrical stimulation in women with overactive bladder: a systematic review and meta-analysis of randomized controlled trials[J]. Neurourol Urodyn, 2022, 41(6): 1258-1269. doi: 10.1002/nau.v41.6
[65]	陈蕾, 吴燕青. 电刺激生物反馈结合盆底肌肉训练改善产后尿潴留患者的临床疗效[J]. 临床与病理杂志, 2021, 41(10): 2371-2376.
	CHEN L, WU Y Q. Clinical effect of electrical stimulation biofeedback combined with pelvic floor muscle training on improving postpartum urinary retention[J]. J Clin Pathol Res, 2021, 41(10): 2371-2376.
[66]	高洁, 吴丽群, 陈游沓, 等. 盆底肌训练联合生物反馈电刺激治疗产后压力性尿失禁的疗效观察[J]. 中华物理医学与康复杂志, 2021, 43(6): 526-528.
	GAO J, WU L Q, CHEN Y T, et al. Effect of pelvic floor muscle training combined with biofeedback electrical stimulation on postpartum stress urinary incontinence[J]. Chin J Phys Med Rehabil, 2021, 43(6): 526-528.
[67]	POLAT DUNYA C, TULEK Z, KÜRTÜNCÜ M, et al. Effectiveness of the transcutaneous tibial nerve stimulation and pelvic floor muscle training with biofeedback in women with multiple sclerosis for the management of overactive bladder[J]. Mult Scler, 2021, 27(4): 621-629. doi: 10.1177/1352458520926666
[68]	侯琳, 商敏. 产后盆底功能障碍性疾病的研究进展[J]. 中国医刊, 2022, 57(2): 145-148.
	HOU L, SHANG M. Research progress of postpartum pelvic floor dysfunction[J]. Chin J Med, 2022, 57(2): 145-148.
[69]	马丹, 马巧媛. 产后尿失禁的发生现状及影响因素分析[J]. 中国临床医生杂志, 2021, 49(7): 853-856.
	MA D, MA Q Y. Analysis of the status quo and influencing factors of postpartum urinary incontinence[J]. Chin J Clin, 2021, 49(7): 853-856.
[70]	田志强, 丁玲, 张俊俊, 等. 高龄产妇产后早期盆底功能状况及其影响因素[J]. 护理研究, 2021, 35(7): 1262-1266.
	TIAN Z Q, DING L, ZHANG J J, et al. Status quo on pelvic floor function in senile parturients at the early stage after childbirth and its influencing factors[J]. Chin Nurs Res, 2021, 35(7): 1262-1266.
[71]	喻琳, 李桂蓉. 盆底功能障碍病人病耻感的研究进展[J]. 全科护理, 2022, 20(12): 1614-1618.
	YU L, LI G R. Research progress of stigma in patients with pelvic floor dysfunction[J]. Chin General Pract Nurs, 2022, 20(12): 1614-1618.
[72]	SABOIA D M, FIRMIANO M L V, BEZERRA K C, et al. Impact of urinary incontinence types on women's quality of life[J]. Rev Esc Enferm USP, 2017, 51: e03266.
[73]	朱兰, 娄文佳. 中国女性盆底康复现状[J]. 中国计划生育和妇产科, 2020, 12(10): 3-4, 8.
	ZHU L, LOU W J. Current status of pelvic floor rehabilitation in Chinese women[J]. Chin J Family Plan Gynecotokol, 2020, 12(10): 3-4, 8.
[74]	WOODLEY S J, HAY-SMITH E J C. Narrative review of pelvic floor muscle training for childbearing women: why, when, what, and how[J]. Int Urogynecol J, 2021, 32(7): 1977-1988. doi: 10.1007/s00192-021-04804-z
[75]	ROMEIKIENĖ K E, BARTKEVIČIENĖ D. Pelvic-floor dysfunction prevention in prepartum and postpartum periods[J]. Medicina (Kaunas), 2021, 57(4): 387.
[76]	EYSENBACH G. What is e-health?[J]. J Med Internet Res, 2001, 3(2): E20. doi: 10.2196/jmir.3.2.e20 pmid: 11720962
[77]	WESSELS N J, HULSHOF L, LOOHUIS A M M, et al. User experiences and preferences regarding an app for the treatment of urinary incontinence in adult women: qualitative study[J]. JMIR Mhealth Uhealth, 2020, 8(6): e17114. doi: 10.2196/17114
[78]	XU P, WANG X, GUO P, et al. The effectiveness of eHealth interventions on female pelvic floor dysfunction: a systematic review and meta-analysis[J]. Int Urogynecol J, 2022, 33(12): 3325-3354. doi: 10.1007/s00192-022-05222-5 pmid: 35616695
[79]	MAZLOOMDOOST D, KANTER G, CHAN R C, et al. Social networking and internet use among pelvic floor patients: a multicenter survey[J]. Am J Obstet Gynecol, 2016, 215(5): 654. e1-654.e10.