产后个体化盆底肌肉康复训练的临床分析

目的评价产后个体化盆底肌肉康复训练对盆底肌肉功能恢复的影响。方法选择2010年6月至2010年8月淄博市妇幼保健院产科住院分娩产后6周复诊的产妇206例,随机分成两组。研究组105例于产后6周开始进行1个疗程的个体化盆底肌肉康复训练(即电刺激联合生物反馈治疗)。对照组101例则由专业医师指导其自行在家做Kegel操,进行单纯的盆底肌肉康复训练。两组均于产后3个月进行一般情况问卷调查及国际尿失禁问卷简表(ICIQ-SF)调查,并进行盆底肌肉张力测定。产后12个月进行问卷调查及盆底肌肉张力测定和POP-Q分度,评价两种盆底肌肉训练的效果。结果研究组产后3个月、产后12个月盆底肌肉张力高于对照组。研究组及对照组产后3个月压力性尿失禁发生率分别为2.9%(3/105)和9.8%(10/101),两组比较差异显著(P<0.05);研究组及对照组产后12个月压力性尿失禁发生率分别为3.8%(4/105)和9.8%(10/101),两组比较差异显著(P<0.05)。研究组及对照组产后12个月POP-QⅠ度脱垂发生率分别为22.8%(24/105)和41.6%(42/101),两组比较差异显著(P<0.05)。结论产后个体化盆底肌肉康复训练能明显提高盆底肌肉张力,降低尿失禁发生率,改善盆腔脏器脱垂,且操作简单、有效、无损伤的特点,值得临床广泛应用。

The Clinical Analysis of Postpartum Pelvic Floor Muscle Individual Convalescent Training in Improving Pelvic Floor Function

Objective To study the effect of postpartum plevic floor muscle individual convalescent training in improving pelvic floor function. Methods A total165 postpartum women 6 weeks after delivery were randomly al-located to a studying （n=105） or a control group （n=101）. The studying group attended a EMG-biofeedback assisted plevic floor muscle training program, The control group received the plevic floor muscle training. The two groups finished the questionaire and were measured the pelvic floor strength 3 months after delivery, and they finished the questionaire and were measure the pelvic floor strength and did the pelvic organ prolapse quantification system 12 months after delivery. Results At follow-up, pelvic floor muscle strength was significantly higher in the training group than in the control group 3 months after delivery and 12 months after delivery. Significantly fewer women in the training group reported stress urinary incontinence：23 of 105 （2.9%） versus 10 of 101 （9.8%） （P〈 0.05） 3 months after delivery and 4 of 105 （3.8%） versus 10 of 101 （9.0%） 12 months after delivery （P〈 0.05）. Significantly fewer women in the training group reported prolapse：24 of 105 （22.8%） versus 42 of 101 （41.6%） （P〈 0.05）. Conclusion Pelvic floor muscle strength improves significantly after intensive pelvic floor muscle training. Stress urinary incontinence prevalence decreases and the vaginal former wall prolapse improves. It is known that its operation is easy available and safe. We should pay more attention to the clinical application of pelvic floor muscle training.