不同妊娠期盆底肌训练对妊娠结局、产妇盆底功能的影响  

Effect of pelvic floor muscle training in different gestation period on pregnancy outcome and maternal pelvic floor function

作　　者：刘威[1] 郭淑惠[1] 卢艳 李荣华 马雪莲 刘静 LIU Wei;GUO Shu-hui;LU Yan(Department of Ob-stetrics and Gynecology,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063000,China)

机构地区：[1]唐山妇幼保健院妇产科,河北唐山063000

出　　处：《临床和实验医学杂志》2025年第4期398-402,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省2018年度医学科学研究重点课题计划(编号:20181329)。

摘　　要：目的探讨妊娠期盆底肌训练不同起始时间(妊娠12周与妊娠20周)对妊娠结局的影响及盆底功能的差异。方法前瞻性选取2021年1月至2024年1月唐山妇幼保健院妇产科门诊孕妇160例,根据随机数字表法分为12周组与20周组,各80例。12周组入组孕妇于孕周12周时开始盆底功能训练,20周组入组孕妇于孕周20周时开始盆底功能训练。统计比较两组孕妇妊娠结局,包括早产、剖宫产、低体重、巨大儿、胎儿宫内窘迫以及产妇总产程时间。产后90 d,比较两组盆底功能,包括盆底肌收缩力量、产后阴道压力[阴道收缩压(VSP)和阴道静息压(VRP)]、阴道收缩持续时间、盆底表面肌电、膀胱结构及功能[膀胱尿道后角(retro-RA)、尿道旋转角(UR)、膀胱颈移动度(BND)、膀胱初始容量(FS)、强烈尿感容量(SD)、最大尿道闭合压力(MUCP)及最大尿流率(Qmax)]、肛门功能[肛提肌裂孔面积(LHA)];比较两组产后并发症[尿失禁、盆腔器官脱垂(POP)]。结果两组早产、剖宫产、巨大儿、胎儿宫内窘迫发生率比较,差异均无统计学意义(P>0.05);12周组产妇总产程时间[(6.20±1.91)h]少于20周组[(7.03±2.04)h],差异有统计学意义(P<0.05)。根据剔除标准,12周组最终共纳入75例,20周组最终共纳入74例。12周组产妇的盆底肌收缩力量Ⅴ级占比为82.67%,高于20周组(74.32%),差异有统计学意义(P<0.05);两组盆底肌收缩力量Ⅲ级、Ⅳ级、Ⅳ~Ⅴ级率差异无统计学意义(P>0.05)。12周组产妇的VSP、VRP分别为(60.14±4.78)、(50.36±4.67)cmH_(2)O,均高于20周组[(57.23±6.32)、(45.38±5.80)cmH_(2)O],阴道收缩持续时间为,(6.57±1.02)s,长于20周组[(6.01±1.42)s],差异均有统计学意义(P<0.05)。盆底表面肌电:12周组前、后静息阶段、Ⅰ类和Ⅱ类肌纤维平均值均高于20周组,其变异性及恢复时间均低于20周组,差异均有统计学意义(P<0.05)。膀胱、肛门功能:12周组膀胱尿道后角、尿道旋转�Objective To investigate the effect of different gestation time of pelvic floor muscle training(12 weeks gestation and 20 weeks gestation)on pregnancy outcome and the difference of pelvic floor function.Methods A total of 160 pregnant women in the Department of Obstetrics and Gynecology Outpatient of Tangshan Maternal and Child Health Hospital from January 2021 to January 2024 were prospectively selected and divided into 12 week group and 20 week group according to random number table,with 80 cases in each group.Pregnant women in the 12-week group started pelvic floor function training at 12 weeks of gestation,and pregnant women in the 20-week group started pelvic floor function training at 20 weeks of gestation.The pregnancy outcomes of the two groups were statistically compared,including premature delivery,cesarean section,low birth weight,macrosomia,fetal distress and total labor time.At 90 days postpartum,pelvic floor function:pelvic floor muscle contraction force,postpartum vaginal pressure[vaginal systolic blood pressure(VSP)and vaginal resting pressure(VRP)],duration of vaginal contraction,pelvic floor surface electromyography,bladder structure and function[retro-vesical angle(RA),urethral rotation angle(UR),bladder neck descent(BND),first ruinary sense(FS),strong urinary sensi-tivity volume(SD),maximum urethral closure pressure(MUCP)and maxi-mum flow rate(Qmax)],anal function[levator hiatus area(LHA)];the postpartum complications[urinary inconti-nence,pelvic organ prolapse(POP)]were compared between the two groups.Results There were no statistically significant differences in the incidence of preterm birth,cesarean section,macro-somia and fetal distress between the two groups(P>0.05).The total labor time of women in the 12-week group[(6.20±1.91)h]was less than that in the 20-week group[(7.03±2.04)h],and the difference was statistically significant(P<0.05).According to the exclusion criteria,a total of 75 cases were included in the 12-week group and 74 cases in the 20-week group.The proportion of grade V

关 键 词：产妇 盆底肌训练 妊娠结局 盆底功能 

分 类 号：R714[医药卫生—妇产科学]