围产期盆底肌锻炼干预对不同分娩方式下盆底功能障碍性疾病的影响  

Effects of perinatal pelvic floor muscle exercise intervention on pelvic floor dysfunction under different delivery modes

作　　者：胡鸣[1] 陈韦君[1] 周静[1] 

机构地区：[1]南昌大学第四附属医院妇产科,江西南昌330003

出　　处：《中国计划生育和妇产科》2017年第10期55-59,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：江西省卫生厅普通科技计划(项目编号:20143118)

摘　　要：目的观察产前、产后连续盆底肌锻炼干预对阴道分娩和剖宫产后盆底功能的影响及盆底功能障碍性疾病的预防效果。方法选择2014年12月至2015年12月在南昌大学第四附属医院妇产科产检、分娩的孕产妇150例,根据分娩方式分为阴道分娩组(A组)106例与剖宫产组(B组)44例;根据产前、产后是否进行盆底功能障碍性疾病(pelvic floor dysfunction,PFD)防治将A组分为干预组(Aa组66例)与未干预组(Ab组40例),B组亦分为干预组(Ba组19例)与未干预组(Bb组25例)。产后6周、12周对以上孕产妇进行问卷调查并检测盆底肌力、阴道静息压、阴道收缩压及阴道收缩持续时间,对结果进行比较和统计学分析。结果 (1)产后6周盆底功能检测:Aa组盆底Ⅰ类肌力、Ⅱ类肌力、阴道静息压、阴道收缩压、阴道收缩持续时间均显著高于Ab组(P<0.05);Ba组Ⅰ类肌力、Ⅱ类肌力均显著高于Bb组(P<0.05),但两亚组患者阴道静息压、阴道收缩压、阴道收缩持续时间比较差异无统计学意义(P>0.05)。(2)产后12周盆底功能检测:Aa组盆底Ⅰ类肌力、Ⅱ类肌力、阴道静息压、阴道收缩压、阴道收缩持续时间均显著高于Ab组(P<0.05);Ba组Ⅰ类肌力、Ⅱ类肌力、阴道静息压、阴道收缩压、阴道收缩持续时间均显著高于Bb组(P<0.05)。(3)产后12周Aa组阴道前壁脱垂、后壁脱垂、尿失禁发生率显著低于Ab组(P<0.05);Ba组阴道前壁脱垂、尿失禁发生率显著低于Bb组(P<0.05)。结论围产期盆底肌锻炼联合生物反馈电刺激可不同程度地改善顺产和剖宫产后盆底肌功能,有助于预防产后盆底功能障碍性疾病的发生。Objective To observe the effect of prenatal and dysfunction in natural delivery and uterine -incision delivery. Methods postnatal continuous pelvic muscle training on pelvic floor A total of 150 pregnant women were selected in The Fourth Affiliated Hospital of Nanchang University from December 2014 to December 2015, and were divided into two groups： the vaginal delivery group （group A, 106 cases） and the cesarean section （group B,44 cases） according to the mode of delivery. According to whether received prenatal and postnatal continuous pelvic muscle training, A group were divided into Aa group （66 cases, received training） and Ab group（40 cases, without training）, while B group were divided into Ba group（ 19 cases, received training） and Bb group（40 cases, without training）. After 6 weeks, 12 weeks, all participants received pelvic floor dysfunction questionnaire, while pelvic floor muscle pressure, vaginal pressure and duration of vaginal contractions were observed and compared. Results @ Pelvic floor function detection after 6 weeks ： type I and type II muscle strength, vaginal resting pressure, vaginal systolic pressure and the duration of vaginal contractions in Aa group were higher than that of the Ab group. The differences had statistical significance （ P 〈 0.05）; Type I and type II muscle strength in Ba group were higher than Bb group, but vaginal resting pressure, vaginal systolic pressure and the duration of vaginal contractions in Ba group had no obvious difference compared to Bb group （ P 〉 0.05 ）. （~） Pelvic floor function detection after 12 weeks： type I and type II muscle strength, vaginal resting pressure, vaginal systolic pressure and the duration of vaginal contractions in Aa group were higher than Ab group. The differences were statistical significant（P 〈0. 05） ; Type I and type II muscle strength, vaginal resting pressure, vaginal systolic pressure and the duration of vaginal contractions in Ba group were higher than Bb group, and the differe

关 键 词：分娩方式 盆底功能障碍 围产期 康复治疗 

分 类 号：R711.23[医药卫生—妇产科学]