国际妇产科学杂志

国际妇产科学杂志 ›› 2013, Vol. 40 ›› Issue (2): 164-166.

• 论著 • 上一篇    下一篇

盆底肌肉训练对产后盆底功能障碍的效果分析

杨 晓 ，刘玉玲   

  1. 450014 郑州大学第二附属医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-04-15 发布日期:2013-04-15
  • 通讯作者: 刘玉玲

Analysis of the Effect of Pelvic Floor Muscle Training in Postpartum Pelvic Floor Dysfunction

YANG Xiao，LIU Yu-ling   

  1. Department of Obstetrics and Gynecology，the Second Affiliated Hospital of Zhengzhou University，Zhengzhou 450014，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-04-15 Online:2013-04-15
  • Contact: LIU Yu-ling

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摘要： 目的：探讨盆底肌肉训练（生物反馈、电刺激、康复器锻炼）对产后早期女性盆底功能障碍的效果分析。方法：选择郑州大学第二附属医院妇产科2010年12月—2011年6月在我院住院分娩产后42 d有不同程度的压力性尿失禁（SUI）或合并盆腔脏器脱垂（S+P）的产妇236例，随机分为3组，治疗组78例于产后42 d进行生物反馈、电刺激、阴道康复器锻炼，哑铃组78例于产后42 d进行阴道康复器（阴道哑铃）锻炼，对照组80例进行产后一般健康教育。3组均于产后3个月和6个月进行盆底肌力测定、流行病学问卷调查、国际尿失禁咨询委员会尿失禁问卷表简表 （ICIQ-SF）调查和POP-Q分度。评价盆底功能障碍的恢复效果。结果：治疗组盆底肌力的恢复优于哑铃组，哑铃组盆底肌力的恢复优于对照组。产后3个月治疗组盆底Ⅰ类、Ⅱ类肌纤维疲劳度比对照组低，而盆底Ⅰ类、Ⅱ类肌纤维肌电压比对照组高，差异有统计学意义（P＜0.05）；产后3个月和6个月时治疗组和哑铃组SUI的发生率均低于对照组，差异均有统计学意义（P＜0.05）；产后3个月时3组S+P的发生率无统计学意义（P＞0.05），而产后6个月时治疗组S+P的发生率低于哑铃组和对照组，差异有统计学意义（P＜0.05）。结论：产后进行盆底肌肉康复训练是提高盆底肌力的一种有效方法，能有效降低SUI和POP的发生率。

关键词: 产后期, 骨盆, 尿失禁, 压力性, 内脏下垂, 问卷调查, 治疗结果

Abstract: Objective：To analysis of the effect of pelvic muscle training （biofeedback，electrical stimulation，rehabilitation exercise） in early postpartum pelvic floor dysfunction. Methods：236 cases in 42 days after childbirth in the Second Affiliated Hospital of Zhengzhou University in 2010 December to 2011 June in department of gynecology and obstetrics，were randomly divided into treatment group（n=78） or dumbbell group（n=78） or control group（n=80）. The treatment group received biofeedback，electrical stimulation and vaginal rehabilitation exercise，the dumbbell group received rehabilitation exercise，the control group received postpartum health education. Three groups at 3 months postpartum，6 months were finished with pelvic floor muscle testing，epidemiological survey，ICIQ-SF，POP-Q index. Results：The treatment group was better than that of pelvic floor muscle strength recorvery dumbbell，dumbbell set of pelvic floor muscle strength recorvery better than the control group. In 3 months postpartum，pelvic floor muscle fiber treatment group class I，class II muscle fiber fatigue were lower than the control group，and treatment group class I，class II muscle fiber voltage were higher than the control group （P＜0.05）. In 3 months and 6 months
postpartum， the incidence rate of SUI in the treatment group and dumbbell group were lower than those of the control group，the differences were statistically significant（P＜0.05）. In 3 months postpartum，the incidence rate of S+P has no statistical significance in three groups（P＞0.05），and in 6 months postpartum， the incidence rate of S+P in the treatment group were lower than that of the dumbbell group and the control group， the differences were statistically significant（P＜0.05）. Conclusions：Postpartum pelvic floor muscle rehabilitation training is an effective method to improve the pelvic floor muscle，which can effectively reduce the incidence of SUI and POP.

Key words: Postpartum period, Pelvis, Urinary incontinence, stress, Visceral prolapse, Questionnaires