不同分娩方式产后盆底障碍的的盆底康复治疗近期疗效观察  

Short Term Effect of Pelvic Floor Rehabilitation Therapy on Postpartum Pelvic Floor Dysfunction with Different Delivery Methods

作　　者：闫梅[1] 王晓银[1] 温琦[1] 张琳琳[1] 李玉梅[1] 

机构地区：[1]四川省妇幼保健院.四川省妇女儿童医院,四川成都610031

出　　处：《四川医学》2017年第11期1295-1300,共6页Sichuan Medical Journal

摘　　要：目的观察不同分娩方式的产妇产后42d检查诊断盆底功能障碍后,采用生物反馈联合电刺激的近期治疗效果。方法选取我院产后42d复诊时经筛查发现盆底功能障碍后进行一个疗程盆底康复治疗的产妇303例,根据不同分娩方式分为水中分娩组54例,剖宫产组55例,产钳/胎吸助产组9例,会阴侧切101例,会阴撕裂组84例,比较盆底治疗前后产妇盆底肌力、SUI及脏器脱垂情况。结果五组不同分娩方式的产妇经盆底康复治疗后,盆底电测肌电值均较训练前增强,差异有统计学意义(P<0.01)。除产钳/胎吸助产组,其他组盆底Ⅰ、Ⅱ类肌力较训练前增强,差异有统计学意义(P<0.01)。除产钳/胎吸助产外,其余各组经盆底康复训练后压力性尿失禁发生率较之前均明显降低,差异有统计学意义(P<0.01)。除产钳/胎吸助产组,其他组阴道前壁脱垂率和子宫脱垂率较训练前降低,差异有统计学意义(P<0.05)。除产钳/胎吸助产组、阴道侧切组,其他组阴道后壁脱垂率较训练前降低,差异有统计学意义(P<0.05)。结论生物反馈联合电刺激治疗不同分娩方式的盆底功能障碍近期疗效显著。对产钳/胎吸助产发生盆底功能障碍的产妇和阴道侧切伴阴道后壁膨出的产妇需要强化疗程。Objective To observe the short-term therapeutic effect of biofeedback combined with electrical stimulation after 42 days postpartum examination of pelvic floor dysfunction in different delivery methods. Methods 303 cases of pregnant women found pelvic floor dysfunction by screeningin our hospital after 42 days postpartum visit and then treated by a course of pelvic floor rehabilitation treatmentwere selected and divided into 54 cases of water delivery group,55 cases of cesarean section group,9 cases of forceps midwifery/fetus aspiration group,101 cases of perineal lobes,84 cases of perineal laceration group.The pelvic floor muscle strength,SUI and organ prolapse before and after pelvic floor treatment were compared. Results After the pelvic floor rehabilitation treatment,the pelvic floor electrical measurement EMG of 5 groups of different delivery methods were increased than those before training,and the difference was statistically significant（ P〈0. 01）.In addition to forceps/fetus aspiration midwifery group,other groups of pelvic I,II muscle increased compared with before training,and the difference was statistically significant（ P〈0. 01）.In addition to forceps/fetus aspiration midwifery group,other groups with pelvic floor rehabilitation training after urinary incontinence rate were significantly lower than before,the difference was statistically significant（ P〈0. 01）.In addition to forceps/fetus aspiration midwifery group,the rates of vaginal anterior wall prolapse and uterine prolapse in other groups were lower than those before training,and the difference was statistically significant（ P〈0. 05）.In addition to forceps/fetus aspiration midwifery group and vaginal lateral incision group,the other group of posterior vaginal prolapse rate decreased compared with before training,the difference was statistically significant（ P〈0. 05）. Conclusion The short-term effect of biofeedback combined with electrical stimulation on pelvic floor dysfunction with different delivery modes is remark

关 键 词：分娩方式 盆底肌力 SUI 脏器脱垂 

分 类 号：R714.6[医药卫生—妇产科学]