[1]贾 亮,周兴翠,王进平,等.孕期盆底肌锻炼对分娩方式、第二产程及尿失禁症状的影响*[J].陕西医学杂志,2020,49(5):581-584,622.
　JIA Liang,ZHOU Xingcui,WANG Jinping,et al.Effects of pelvic muscle exercise during pregnancy on delivery approaches,duration of second stage of labor and symptoms of urinary incontinence[J].,2020,49(5):581-584,622.
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孕期盆底肌锻炼对分娩方式、第二产程及尿失禁症状的影响*

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年5期
页码:
581-584,622
栏目:
临床研究
出版日期:
2020-05-05

文章信息/Info

Title:
Effects of pelvic muscle exercise during pregnancy on delivery approaches,duration of second stage of labor and symptoms of urinary incontinence
文章编号:
DOI:10.3969/j.issn.10007377.2020.05.019
作者:
贾 亮1; 周兴翠1; 王进平1; 王 娜2△
1.西北妇女儿童医院(西安710061); 2.兵器工业五二一医院(西安710065)
Author(s):
JIA Liang; ZHOU Xingcui; WANG Jinping; et al.
Northwest Women and Children's Hospital(Xi'an 710061)
关键词:
盆底肌锻炼;  孕期;  产后;  分娩方式;  第二产程;  压力性尿失禁
Keywords:
Pelvic muscle exercise;  Pregnancy;  Postpartum;  Delivery approach;  Second stage of labor;  Stress urinary incontinence
分类号:
R715.3
文献标志码:
A
摘要:
目的:探讨孕期进行盆底肌锻炼与分娩方式、第二产程时长及产前、产后尿失禁症状的相关性。方法:选择620例早中期孕妇,对其宣传并使其掌握盆底肌锻炼方法,填写尿失禁问卷表简表评估尿失禁情况,根据孕期每周进行盆底肌锻炼的次数分为五组,即经常锻炼组(≥4次); 有时锻炼组(3～4次); 偶尔锻炼组(2～3次); 很少锻炼组(1～2次); 不锻炼组(<1次),统计各组的例数、分析孕期盆底肌锻炼与分娩方式、第二产程时长的相关性,比较各组在初诊、分娩前、产后3 d、产后6周时的尿失禁问卷表简表分值。结果:①孕期经常锻炼组50例(8.06%),有时锻炼组9例(1.45%),偶尔锻炼组14例(2.26%),很少锻炼组20例(3.23%),不锻炼组527例(85.00%)。②孕期进行盆底肌锻炼与分娩方式(χ2=2.30,P=0.67)、第二产程时长(F=0.93,P=0.45)均无相关性。③孕期进行盆底肌锻炼与产前、产后尿失禁分值相关(F=2.25,P=0.008); 尿失禁分值在分娩前时,经常锻炼组低于不锻炼组; 在产后3 d时,经常锻炼组、有时锻炼组均低于不锻炼组及很少锻炼组; 在产后6周时,经常锻炼组低于不锻炼组及很少锻炼组。结论:孕期大多数孕妇仍不能坚持有效的锻炼; 孕期进行盆底肌锻炼与分娩方式、是否会阴侧切以及第二产程时长均无相关性; 孕期进行盆底肌锻炼可以显著改善产前及产后尿失禁相关症状。
Abstract:
Objective:To explore the correlation between pelvic muscle exercise during pregnancy and delivery approaches,the duration of the second stage of labor and the symptoms of urinary incontinence before and after delivery. Methods:A total of 620 pregnant women in the early and middle period who underwent prenatal care were selected to received instructions about how to perform the exercises correctly and fill in the brief form of urinary incontinence questionnaire,so as to evaluate the situation of urinary incontinence. Based upon the times of exercise per week,they were divided into 5 groups which were regular group(≥4 times),sometimes group(3-4 times),occasional group(2-3 times),rarely group(1-2 times)and never group(<1 time). The numbers of individual,delivery approach,duration of second stage of labor in all groups were analyzed. The scores of the urinary incontinence questionnaire at initial diagnosis,prepartum,3 days postpartum and 6 weeks postpartum were compared. Results:A total of 50 cases(8.06%)in regular group,9 cases(1.45%)in sometimes group,14 cases(2.26%)in occasional group,20 cases(3.23%)in rarely group,and 527 cases(85.00%)in never group. There was no correlation between pelvic muscle exercises during pregnancy and delivery approaches(χ2=2.30,P=0.67)and duration of the second stage of labor(F=0.93,P=0.45). The pelvic muscle exercises during pregnancy was related to the scores of urinary incontinence(F=2.25,P=0.008)before and after delivery. The score of urinary incontinence in the regular group before delivery was lower than never group. At 3 days postpartum,the score of urinary incontinence in the regular group and sometimes group was lower than that in the never group and rarely group. At 6 weeks postpartum,the score of urinary incontinence in the regular group was lower than that in the never group and rarely group. Conclusion:Even if the advantages of pelvic muscle exercises during pregnancy are known,most pregnant women still can not perform exercise effectively. Pelvic muscle exercises during pregnancy is not related to the delivery approaches,lateral episiot-omy or not,and the duration of the second stage of labor. Pelvic muscle exercises can significantly improve prepartum and postpartum urinary incontinence-related symptoms.

参考文献/References:

[1] 李志毅,朱 兰,徐 涛,等.中国城市地区女性盆腔器官脱垂临床流行病学调查[J]. 中华医学杂志,2019,99(11):857-861.
[2] Kurkijarvi K,Aaltonen R,Gissler M,et al. Pelvic organ prolapse surgery in Finland from 1987 to 2009:A national register based study[J]. Eur J Obstet Gynecol Reprod Biol,2017,214:71.
[3] 赵丹阳,杨建梅,季梅英,等. 盆底重建手术对盆腔器官脱垂患者生活质量及盆底肌肌电的影响[J]. 陕西医学杂志,2016,45(7): 822-824.
[4] 陈 萰. 产后盆底肌锻炼对产妇盆底肌康复的效果[J]. 中国计划生育和妇产科,2015,7(11):54-56.
[5] 杨玉培,刘玉玲,石莹莹,等.盆底肌肉锻炼及锻炼时机对产后盆底功能的影响研究[J].中国全科医学,2016,19(26):3170-3174.
[6] 陈汝君,盛 婵,陈亚萍. 盆底肌锻炼对改善产后女性盆底功能临床疗效的Meta分析[J]. 现代妇产科进展,2019,28(1):25-28.
[7] 郭 毅.盆底肌锻炼对产后尿潴留的康复护理研究[J]. 中国医药指南,2015(6):26-26.
[8] 靳宝兰,刘亚玲,张晨凌,等. 产后盆底功能障碍康复治疗及护理的效果观察[J]. 陕西医学杂志,2018,47(4): 540-542.
[9] 梁茹英. 电刺激联合生物反馈对非脱垂子宫切除术患者盆底功能的康复疗效[J]. 陕西医学杂志,2016,45(8): 1001-1002.
[10] 王新侠,徐贵红,徐桂梅,等. 多维健康教育模式在孕产妇妊娠及产后盆底肌锻炼中的运用[J]. 临床与病理杂志,2017(4):707-712.
[11] 蔡 舒,任 旭,宋均仿,等. 基于保护动机理论的健康教育对社区女性压力性尿失禁患者盆底肌锻炼依从性的影响[J]. 护理学报,2015(11):64-67.
[12] 初剑英,黄 静,杨海燕,等. 盆底肌锻炼对产程的影响及产后尿失禁的预防[J]. 中华预防医学杂志,2009,43(12):1134-1135.
[13] 胡 峥,齐国华,吴燕华. 盆底肌锻炼持续性指导对初产妇母婴分娩结局的影响[J]. 海南医学,2014(9):1351-1352.
[14] 黄建桃. 盆底肌锻炼护理干预对初产妇分娩结局及盆底功能的影响[J].河北医学,2014(3):513-516.
[15] 王 新,李桂友,邓美莲. 盆底肌锻炼持续性指导对分娩结局及盆底肌力的影响[J]. 中华护理杂志,2013,48(4):308-310.
[16] 刘 莉,穆 靓,韦爱华,等.子宫脱垂患者肛提肌形态经会阴盆底三维超声研究[J]. 陕西医学杂志,2017,46(12): 1728-1730.

备注/Memo

备注/Memo:
*陕西省卫生健康科研基金资助项目(2018D039)
更新日期/Last Update: 2020-07-28