摘要
目的探讨不同盆底肌肉锻炼(pelvic floor muscle training,PFMT)时机对女性产后盆底肌力恢复及盆底功能的影响。方法选取2015年临沂市妇女儿童医院经阴道分娩的足月初产妇240例,按照随机数字表法分为产后7 d组、产后42 d组和对照组,各80例。对照组给予常规健康宣教,产后7 d组和产后42 d组分别于产后7 d、产后42 d采用Kegel训练法进行为期6周PFMT,分别于产后42 d、3月、6月、1年时检测盆底肌力、阴道静息压(vaginal resting pressure,VRP)、阴道收缩压(vaginal systolic pressure,VSP)、阴道收缩持续时间,随访产妇压力性尿失禁(stress urinary incontinence,SUI)和子宫脱垂情况。结果 (1)产后7 d组在随访产后42 d、3月、6月、1年时盆底肌力Ⅳ、Ⅴ级例数、VRP、VSP及阴道收缩持续时间高于产后42 d组与对照组(P<0.05)。(2)产后42 d组在随访6个月、1年时盆底肌力Ⅳ、Ⅴ级例数、VRP、VSP及阴道收缩持续时间高于对照组(P<0.05)。(3)3组产妇随访期间子宫脱垂发生率比较差异无统计学意义(P>0.05)。(4)产后7 d组在随访产后42 d、3月、6月、1年时SUI发生率明显低于其他两组(P<0.05)。结论初产妇在经阴道分娩后会出现不同程度的盆底功能障碍,早期进行PFMT对于恢复盆底肌力,降低SUI发生率具有重要意义。
Objective To explore the effect of different training time of pelvic floor muscle training on postpartum pelvic floor function and recovery of pelvic floor muscle strergth. Methods 240 cases of full - term primiparous women who were given vaginal delivery in Linyi City Women and Children Hospital in 2015 were divided into postpartum 7 d group, postpartum 42 d group and control group according to the random number table method. The control group was given routine health education, the postpartum 7 d group and the postpartum 42 d group received Kegel training for 6 - week PFMT at 7 d postpartum and 42 d postpartum, respectively. The pelvic floor muscle strength, vaginal resting pressure （ VPR ）, vaginal systolic pressure （ VSP）, duration of vaginal constriction were measured at postnatal 42 d, 3 months, 6 months and 1 year respectively, followed - up maternal stress urinary incontinence（SUI） and uterine prolapse. Results ① The pelvic muscular strength of grade IV and V, VRP, VSP and duration of vaginal constriction inpostnatal 7 d group when following - up 42 d ,3 months ,6 months, 1 year were significantly higher than those of postpartum 42 d group, the difference was statistically significant （ P 〈 0. 05 ）. ② The pelvic muscular strength of grade IV and V , VRP, VSP and duration of vaginal constriction in postnatal 42 d group when following - up 6 months, 1 year were significantly higher than those of control group （ P 〈 0. 05 ）. ③ There was no significant difference in the incidence of uterine prolapse between the three groups during follow - up period. ④ The incidence of SUI was significantly lower in the postpartum 7 d group than that of the other two groups after 42 d, 3 months, 6 months and 1 year follow- up（ P 〈 0.05 ）. Conclusion The primipara after vaginal delivery will have varying degrees of pelvic floor dysfunction. Early pelvic floor muscle training has great significance to restore pelvic floor muscle strength and reduce the incidence of stress urinary incontinen
作者
林晓杰
LIN Xiao -fie(Department of Social Protection ,Linyi City Women and Children Hospital,Linyi Shandong 276000 ,P. R. Chin)
出处
《中国计划生育和妇产科》
2018年第7期37-41,共5页
Chinese Journal of Family Planning & Gynecotokology
关键词
盆底肌肉锻炼
不同时机
盆底功能
压力性尿失禁
pelvic floor muscle training
different time
pelvic floor function
stress urinary incontinence
