| 摘要: |
| ［摘要］ 目的 观察神经肌肉电刺激治疗产后腹直肌分离（DRA）的效果，并分析其对剪切波弹性成像（SWE）杨氏模量指标的影响。方法 招募2022年1月至2024年3月柳州市柳铁中心医院收治的产后DRA患者80例，采用随机数字表法将其分为对照组和观察组，每组40例。观察组接受神经肌肉电刺激治疗，对照组接受产后收腹带治疗，两组康复治疗时间均为10 d。采用高频超声测量患者静息及屈曲状态下脐上2 cm、脐上5 cm、脐平面及脐下2 cm的腹直肌间距（IRD），并记录双侧腹直肌厚度。采用SWE测量腹直肌脐平面的杨氏模量指标，包括右侧组织弹性平均值（Emean R）、右侧组织弹性最大值（Emax R）、右侧组织弹性最小值（Emin R）、左侧组织弹性平均值（Emean L）、左侧组织弹性最大值（Emax L）以及左侧组织弹性最小值（Emin L）。比较两组临床疗效。结果 治疗后，观察组静息及屈曲状态下脐上5 cm、脐上2 cm、脐平面及脐下2 cm的IRD均较对照组更小，双侧腹直肌厚度及各SWE杨氏模量指标均大于对照组，差异有统计学意义（P<0.05）。观察组临床总体有效率显著高于对照组（87.50% vs 65.00%， χ2=5.591，P=0.018）。结论 神经肌肉电刺激治疗可有效改善产后DRA患者的腹直肌形态和力学性能，高频超声联合SWE为临床疗效评估提供了客观指标。 |
| 关键词: 高频超声 剪切波弹性成像 神经肌肉电刺激 产后腹直肌分离 |
| DOI：10.3969/j.issn.1674-3806.2026.04.14 |
| 分类号:R 493 |
| 基金项目:广西卫生健康委员会科研课题（编号：Z20200203） |
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| Observation on the effect of neuromuscular electrical stimulation in treatment of postpartum diastasis recti abdominis and its influence on Young′s modulus indices of shear wave elastography |
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PAN Huangui, PAN Yongshou, JIANG Yunxiu, MAI Lihuan, ZHU Shangning, PENG Chunyan
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Department of Ultrasound Medicine, Liuzhou Municipal Liutie Central Hospital, Liuzhou 545007, China
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| Abstract: |
| ［Abstract］ Objective To observe the effect of neuromuscular electrical stimulation(NMES) in treatment of postpartum diastasis recti abdominis(DRA) and to analyze its influence on Young′s modulus indices of shear wave elastography(SWE). Methods A total of 80 patients with postpartum DRA who were admitted to Liuzhou Municipal Liutie Central Hospital from January 2022 to March 2024 were recruited and divided into control group and observation group by random number table method, with 40 patients in each group. The observation group received NMES treatment, while the control group received postpartum abdominal compression belt treatment. The duration of rehabilitation treatment was 10 days for both groups. High-frequency ultrasound(HFUS) was used to measure the values of inter-rectus distance(IRD) 2 cm above the umbilicus, 5 cm above the umbilicus, at the level of the umbilicus and 2 cm below the umbilicus at the resting and flexed states in the patients, and the thickness of the bilateral rectus abdominis muscles was recorded. The Young′s modulus indices of the umbilical plane of rectus abdominis muscles was measured by using SWE. The Young′s modulus indices included the mean value of right tissue elasticity(Emean R), the maximum value of right tissue elasticity(Emax R), the minimum value of right tissue elasticity(Emin R), the mean value of left tissue elasticity(Emean L), the maximum value of left tissue elasticity(Emax L), and the minimum value of left tissue elasticity(Emin L). The clinical efficacy was compared between the two groups. Results After treatment, the values of IRD 5 cm above the umbilicus, 2 cm above the umbilicus, at the level of the umbilicus and 2 cm below the umbilicus at the resting and flexed states in the patients in the observation group were less than those in the control group, and the thickness of the bilateral rectus abdominis muscles and the Young′s modulus indices of SWE in the observation group were greater than those in the control group, with statistically significant differences(P<0.05). The overall clinical effective rate of the observation group was significantly higher than that of the control group［87.50% vs 65.00%, χ2=5.591, P=0.018］. Conclusion NMES therapy can effectively improve the morphology and mechanical properties of the rectus abdominis muscles in patients with postpartum DRA. HFUS combined with SWE provides objective indicators for clinical efficacy evaluation. |
| Key words: High-frequency ultrasound(HFUS) Shear wave elastography(SWE) Neuromuscular electrical stimulation(NMES) Postpartum diastasis recti abdominis |
