不同时机的个体化产后盆底康复治疗对盆底肌作用分析  

Effect of individual pelvic floor rehabilitation treatment at different postpartum periods on pelvic floor muscle function

作　　者：马喆[1] 李环[1] 张薇颖 吴瑞芳[1] 肖爱民[1] 

机构地区：[1]广东省深圳市北京大学深圳医院妇产科,深圳518036

出　　处：《生殖医学杂志》2015年第1期32-36,共5页Journal of Reproductive Medicine

摘　　要：目的评估产后早期不同时间段开始进行的个体化盆底康复治疗对女性盆底肌力及盆底功能改善的作用。方法选取2010年1月至2011年12月期间,回我院门诊进行产后访视,手法检测盆底肌力≤3级的产妇174例作为研究对象,分为观察组与对照组。按照产后开始进行盆底康复治疗的不同时间将观察组（125例）分为3组：A组（39例）,产后42～56d;B组（48例）,产后57～70d;C组（38例）,产后71～91d10对照组（D组,49例）：产后6～8周,只进行产后盆底康复知识的宣教。观察组各组的产妇治疗前进行盆腹动力学及盆底肌电生理指标检测,按照肌力等异常的具体情况选择个体化的低频电刺激联合生物反馈治疗。治疗结束时及结束后6个月复测治疗前所检测指标。对照组产妇于产后6～8周及产后6个月回院进行同样的盆底指标检测。结果各个观察组在治疗结束时及治疗结束后6个月,所检测数据与治疗前相比较,盆底肌Ⅰ、Ⅱ类肌纤维的肌力和静态张力都有显著提高,最大肌电位数值增加,肌肉疲劳度得到改善,差异具有统计学意义（P〈0.05）。观察组各组在治疗结束时、结束后6个月相比较,组间各项检测数据对比无显著性差异（P〉0.05）。结论产后早期不同时间段开始进行的盆底个体化康复治疗,均可以显著提高盆底肌力及明显改善盆底功能。临床上根据实际情况在产后早期的不同时机都可以积极进行盆底康复治疗,值得临床推广应用。Objective： To assess the effect of individual pelvic floor rehabilitation treatment at different postpartum periods on pelvic floor muscle function. Methods： A total of 174 patients who came back to our hospital for postpartum visit and their pelvic floor muscle strength less or equal to grade 3 were recruited to the study from January 2010 to December 2011. The patients（n=125）were received pelvic floor rehabilitation as observation group and divided to three groups： Group A（n= 39） （treated at postpartum day 42-56） , Group B（n= 48） （treated at postpartum day 57-70）, and Group C（n = 38） （treated at postpartum day 71-91） according to treatment at different postpartum periods. The patients in control group or GroupD（n= 49 ） were only received the knowledge education of postpartum pelvic floor rehabilitation at postpartum day 42-56. The patients in the observation group were received individual low-frequency electrical stimulation combined biofeedback treatment according to the different types of muscle fiber muscle damage identified by detecting maternal abdominal muscle strength and pelvic floor electrical physiological index. The patients were received the same examination at the end of treatment and six months later again. The patients in the control group were received the same examination at the maternal postpartum visit and 6 months postpartum. Results： The muscle fiber strength and static tension of pelvic floor muscles type I ～ Ⅱ and the muscle fatigue were significantly improved, and the largest numerical maximum muscle potential in electromyogram（EMG） was also significantly increased at the end of treatment and six months later in the patients of the obse）vation group after treatment （P〈0.05）. There were no significant differences in all kinds of indexes among the each group in the observation groups（P〉0.05）. Conclusions： The individualized rehabilitation of the pelvic floor at different early postpartum periods can enhance pelvic floor mus

关 键 词：不同时机 盆底康复治疗 盆底肌力 盆底功能 

分 类 号：R[医药卫生]