[1]胡鸣,陈韦君*,周静.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[J].中国计划生育和妇产科,2017,(10):55-59.
　HU Ming,CHEN Wei-jun*,ZHOU Jing.Effects of perinatal pelvic floor muscle exercise intervention on pelvic floor dysfunction under different delivery modes[J].Chinese Journal of Family Planning & Gynecotokology,2017,(10):55-59.
点击复制

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
分享到：

《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年10期
页码:
55-59
栏目:
论著与临床
出版日期:
2017-10-25

文章信息/Info

Title:
Effects of perinatal pelvic floor muscle exercise intervention on pelvic floor dysfunction under different delivery modes
作者:
胡鸣; 陈韦君*; 周静
南昌大学第四附属医院妇产科
Author(s):
HU Ming;  CHEN Wei-jun*;  ZHOU Jing
Department of Obstetric and Gynecology, The Fourth Affiliated Hospital of Nanchang University, Nanchang Jiangxi 330003，P.R.China
关键词:
分娩方式; 盆底功能障碍; 围产期; 康复治疗
Keywords:
delivery mode;  pelvic floor dysfunction; perinatal period;  rehabilitation therapy
分类号:
R 711.23
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。
Abstract:
ObjectiveTo observe the effect of prenatal and postnatal continuous pelvic muscle training on pelvic floor dysfunction in natural delivery and uterine-incision delivery. MethodsA 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. Results① 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). ② 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 differences were statistical significant(P<005). ③ After 12 weeks, the prolapse rates of the anterior vaginal wall and posterior vaginal wall, the rate of urinary incontinence in Aa group were lower than that of Ab group, and the prolapse rates of the anterior vaginal wall and the rate of urinary incontinence in Ba group were lower than that of Bb group(P<005). ConclusionThe prenatal and postnatal continuous pelvic muscle training and biofeedback combined with electrical stimulation could improve the pelvic floor muscle strength with different degree in natural delivery and uterine-incision delivery, and the training could prevent the pelvic floor dysfunction effectively.

参考文献/References:

［1］周亚萍．不同分娩方式对产妇产后近期性功能及盆底结构功能的影响比较 ［J］．中国现代医学杂志，2014，24（31）：88-91． ［2］于迎春，宋俊华，于凤．产科因素对产后早期盆底功能障碍性疾病发生的影响 ［J］．中国妇产科临床杂志，2011，12（2）：88-91． ［3］Kepenekci I, Keskinkilic B, Akinsu F, et al. Prevalence of pelvic floor disorders in the female population and the impact of age, mode of delivery, and parity ［J］. Dis Colon Rectum, 2011, 54(1): 85-94. ［4］蒋红，吴艳．产后盆底肌电刺激对不同分娩方式盆底肌力近期疗效观察 ［J］．实用妇产科杂志，2012，28（2）：145-147． ［5］林丽莎，黄吴健，宋岩峰，等．分娩方式对产妇早期盆底功能障碍的影响分析 ［J］．实用妇产科杂志，2012，28（9）：785-788． ［6］李环，吴瑞芳，光晓燕，等．产后盆底康复时间选择对尿失禁及盆底肌的影响研究［J］．中国全科医学，2013，16（31）：3699-3704． ［7］邓晓云，于雅，吴秀娜，等．产后盆底康复治疗对盆底肌力恢复效果的影响［J］．中华现代护理杂志，2013，19（20）：2393-2395． ［8］李林，邓彦东，陈然，等．分娩方式对阴道静息压力、盆底肌肉力量和耐力的影响 ［J］．中国现代医学杂志，2016，26（9）：67-71． ［9］Botelho S, Riccetto C, Herrmann V, et al. Impact of delivery mode on electromyographic activity of pelvic floor: comparative prospective study ［J］. Neurourol Urodyn, 2010, 29(7): 1258-1261.

相似文献/References:

[1]粟桂香.脐带绕颈经阴道分娩150例临床回顾分析[J].中国计划生育和妇产科,2010,(04):0.
　SU Gui-xiang.[J].Chinese Journal of Family Planning & Gynecotokology,2010,(10):0.
[2]胡会铭.胎膜早破169例临床分析[J].中国计划生育和妇产科,2012,(02):0.
　HU Hui-ming.[J].Chinese Journal of Family Planning & Gynecotokology,2012,(10):0.
[3]柳宛璐,吴媛媛,乔福元,等.分娩方式与产后避孕[J].中国计划生育和妇产科,2012,(06):0.
　LIU Wan-lu,WU Yuan-yuan,QIAO Fu-yuan* Deptment of Obstetrics and Gynecology,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2012,(10):0.
[4]牛琼华.孕期综合管理对产妇分娩方式及母婴结局的影响[J].中国计划生育和妇产科,2014,(06):0.
　Niu Qiong-hua,Nursing.[J].Chinese Journal of Family Planning & Gynecotokology,2014,(10):0.
[5]王丽红.甘肃省酒泉市肃州区1 830例女性盆底功能障碍因素分析[J].中国计划生育和妇产科,2014,(06):0.
　Wang Li-hong,[J].Chinese Journal of Family Planning & Gynecotokology,2014,(10):0.
[6]王国育.妊娠期糖尿病孕妇孕前体质量指数对分娩方式和新生儿体质量的影响[J].中国计划生育和妇产科,2014,(07):0.
　WANG Guo-yu,[J].Chinese Journal of Family Planning & Gynecotokology,2014,(10):0.
[7]王淑静,邓晓岚,菅莹莹,等.不同分娩方式对盆底功能的影响及电刺激治疗的疗效分析[J].中国计划生育和妇产科,2016,(01):0.
　WANG Shu-jing,DENG Xiao-lan,JIAN Ying-ying,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2016,(10):0.
[8]刘亚萍,孟海霞*.晚期早产的高危因素及不同分娩方式对新生儿预后影响的研究[J].中国计划生育和妇产科,2017,(3):53.
　LIU Ya-ping,MENG Hai-xia*.Study on the risk factors of late premature delivery and the influences of different modes of delivery on neonatal prognosis[J].Chinese Journal of Family Planning & Gynecotokology,2017,(10):53.
[9]谢洁玲*,蔡叶萍.宫颈上皮内瘤变宫颈环形电切除术后对育龄妇女生育的影响[J].中国计划生育和妇产科,2017,(5):40.
　XIE Jie-ling*,CAI Ye-ping.Effects of LEEP on fertility of childbearing age women with cervical intraepithelial neoplasia[J].Chinese Journal of Family Planning & Gynecotokology,2017,(10):40.
[10]郭蕾*,叶璐,张艺.神经肌肉刺激治疗仪对女性盆底功能障碍疗效 及预后的影响[J].中国计划生育和妇产科,2017,(7):31.
　GUO Lei*,YE Lu,ZHANG Yi.Effect of neuromuscular stimulation therapy instrument on efficacy and prognosis of female pelvic floor dysfunction[J].Chinese Journal of Family Planning & Gynecotokology,2017,(10):31.
[11]闫梅,王晓银,温琦,等.不同产科因素对产后妇女盆底功能障碍的影响[J].中国计划生育和妇产科,2015,(08):0.
　YAN Mei,WANG Xiao-yin,WEN Qi,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2015,(10):0.

备注/Memo

备注/Memo:
江西省卫生厅普通科技计划（项目编号:20143118 ）
更新日期/Last Update: 2017-10-25