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

Abstract

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

CLC Number:

R694

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.

Figures/Tables 9

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

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Pelvic floor rehabilitation domestic and abroad in the last decade: a visualized analysis

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排名	CNKI			WOS
排名	关键词	出现频次	中心度	关键词	出现频次	中心度
1	产后	282	0.22	urinary incontinence	304	0.01
2	盆底功能	217	0.12	women	222	0.01
3	盆底肌力	167	0.09	quality of life	220	0.04
4	盆底康复	162	0.37	pelvic floor muscle training	193	0.02
5	产妇	127	0.10	stress urinary incontinence	140	0.06
6	电刺激	122	0.09	management	128	0.04
7	尿失禁	117	0.25	prevalence	105	0.05
8	生物反馈	109	0.09	symptom	91	0.08
9	产后康复	64	0.10	impact	81	0.07
10	康复训练	55	0.13	randomized controlled trial	77	0.07

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