摘要
目的:探讨产后早期盆底肌肉训练及电刺激预防和治疗盆底功能障碍性疾病(pelvic floor dysfunction,PFD)的有效性,PFD发生的相关因素。方法:选取阴道分娩产后早期盆底康复训练的初产妇284例作为研究对象。分为3个研究组:低风险组(n=98)、高风险组(n=92)和PFD组(n=94);3个研究组根据是否行盆底康复治疗再分为观察组和对照组。比较各组盆底康复治疗前后PFD的发生及改善、盆底肌肉的肌力变化情况,分析阴道分娩后PFD发生的危险因素。结果:3组结果表明:低风险组治疗前后盆底肌力变化及PFD的发生,差异无统计学意义;高风险组及PFD组治疗后盆底肌肉的肌力及PFD较治疗前明显提高(P<0.05);会阴侧切、阴道助产、会阴裂伤、巨大儿、第二产程延长、产后尿潴留比较,高风险组和PFD组明显高于低风险组(P<0.05);高风险组与PFD组比较,会阴侧切、会阴裂伤、巨大儿、第二产程延长、产后尿潴留比例明显提高(P<0.05);3组分娩镇痛比较差异无统计学意义;患者年龄、体重指数、是否阴道助产、新生儿出生体重、第二产程是否延长、产后是否发生尿潴留是PFD发生的独立因素(P<0.05),而分娩镇痛与PFD发生无相关性。结论:对阴道分娩存在PFD高危因素的产妇,进行早期盆底肌肉训练及电刺激康复治疗,可预防阴道分娩后PFD的发生,是PFD非手术治疗的有效方法。
Objectives : To explore the effectiveness of early postpartum pelvic floor muscle training and electrical stimulation in the prevention and treatment of pelvic muscle dysfunction (PFD), and the related factors of PFD. Methods : This study included 284 nulliparous women of early pelvic floor rehabilitation from vaginal birth during 2015 and 2017 from Chengdu Fifth People's Hospital. The trials included three groups: low-risk group ( n =98), high-risk group ( n =92), and PFD group ( n =94). Each group was subdivided into test and control subgroups. The incidence and improvement of PFD before and after pelvic floor rehabilitation, and the muscle strength of pelvic floor muscles were compared. Risk factors for PFD after vaginal birth were analyzed. Results : There was no significant difference in pelvic floor muscle strength and PFD before and after treatment in the low-risk group ( P > 0.05 );the muscle strength and PFD of the pelvic floor muscles in the high-risk group and the PFD group were significantly improved after treatment as compared with those before treatment ( P < 0.05 );the incidence of episiotomy, vaginal delivery, perineal laceration, macrosomia, prolonged second stage of labor, and postpartum urinary retention was significantly higher in the high-risk group and the PFD group than in the low-risk group ( P < 0.05 );the incidence of episiotomy, perineal laceration, macrosomia, prolonged second stage of labor, and postpartum urinary retention was significantly higher in the high-risk group than that in the PFD group ( P < 0.05 ). There was no significant difference in labor analgesia among the three groups ( t = 0.09 , P >0.05 );patient's age, body mass index, vaginal delivery or not, neonatal birth weight, length of second labor, and postpartum urinary retention were the independent factors of PFD ( P<0.05 ), but there was no correlation between labor analgesia and PFD ( P >0.05 ). Conclusion : For women with vaginal birth who have PFD risk factors, early pelvic floor muscle training and electrical stimulation rehabilitation can prevent the occurrence of PFD after vaginal birth. It is an effective method for non-surgical treatment of PFD.
作者
李超
李渊
李芷茹
余娅
刘颖
彭晓梅
李兰
Li Chao;Li Yuan;Li Zhiru(Chengdu Fifth People's Hospital, chengdu 611130,China)
出处
《中国康复》
2019年第1期22-25,共4页
Chinese Journal of Rehabilitation
基金
四川省卫生计生委科研课题项目(17PJ252)
关键词
盆底肌肉训练
电刺激治疗
盆底康复
pelvic muscle training
electrical stimulation
pelvic floor rehabilitation
作者简介
李超(1982-),男,主治医师,主要从事产后康复方面的研究。
