摘要
目的探讨阴道分娩女性盆底肌损伤的影响因素及早期盆底肌康复治疗的疗效。方法选取2016年10月至2017年8月产后6周常规复检的阴道分娩产妇324例为研究对象，324例均行盆底功能筛查，依据是否出现盆底肌损伤分为盆底肌力损伤组与盆底肌力正常组，比较两组患者的临床特征，了解盆底肌力受损的影响因素；同时，盆底肌损伤组患者行盆底肌早期康复治疗，比较治疗前及治疗后3个月的盆底肌肉张力。结果283例产妇发生盆底肌肉损伤，发生率为87．3％；两组产妇年龄、体质指数（BMI）、分娩孕周、分娩方式、侧切、第一产程时间比较差异未见统计学意义（P〉0．05），两组产妇产次、第二产程时间、新生儿体质量比较差异有统计学意义（P〈0．05）；多因素Logistic回归分析发现，产次、第二产程时间、新生儿体质量是导致产妇盆底肌损伤的危险因素；行早期盆底肌康复治疗后3个月产妇Ⅰ、Ⅱ类肌纤维肌电值、疲劳度均显著升高，与治疗前比较，差异有统计学意义（P〈0．05）。结论阴道分娩易导致盆底肌力损伤，其中多产次、第二产程时间延长、新生儿体质量过大是导致产妇盆底肌损伤的高危因素，早期盆底肌康复治疗可有效改善产妇盆底肌肌力，促进其盆底肌功能恢复。
Objective To investigate the influence factors of female pelvic floor muscle injury in vaginal delivery and the curative effect of early pelvic floor muscle rehabilitation. Methods From Octo- ber 2016 to August 2017, 324 cases of vaginal delivery women of postpartum routine review after 6 weeks postpartum were selected as the subjects. And the 324 cases were divided into pelvic floor muscle injury group and normal pelvic floor muscle group according to the pelvic floor muscle injury or not. The clinical features of the two groups were compared and the factors affecting the damage of pelvic floor muscle strength were understood. Meanwhile, the pelvic floor muscle injury group was treated with pelvic floor muscle early rehabilitation, and the pelvic floor muscle tension was compared before and 3 months after treatment. Results Pelvic floor muscle injury occurred in 283 cases of parturients, the incidence was 87.3%. There were no significant differences in age, BMI, gestational weeks, delivery mode, side cut, the first stage labor time between the two group, and there were significant differences in the delivery time, the second stage labor time, neonatal body weight between the two groups. Multivariate Logistic re- gression analysis showed that the delivery time, the second stage labor time and neonatal body weight were the risk factors causing maternal pelvic floor muscle injury. Compared with those before treatment, the electromyographic value and fatigue degree of the class I and [[ muscle fibers 3 months after treat- ment increased significantly, and the difference was significant （P 〈 0. 05 ）. Conclusions Vaginal de- livery can lead to pelvic muscle injury, among them, delivery times, the second stage labor time, neo- natal body mass are the risk factors for pelvic floor muscle injury, the early rehabilitation therapy of pelvic floor muscle can effectively improve the muscle strength of pelvic floor muscle and promote the function recovery of pelvic floor muscle.
出处
《中国实用医刊》
2018年第16期36-38,42,共4页
Chinese Journal of Practical Medicine
关键词
阴道分娩
盆底肌肌力
影响因素
康复训练
疗效
Vaginal delivery
Pelvic floor muscle strength
Influencing factors
Rehabilitation
