盆底肌功能训练在防治产后尿失禁中的作用

Training at the muscle function control postpartum incontinence

目的探讨产后进行盆底肌肉锻炼(pelvic floor muscles exercise,PFMT)对产后压力性尿失禁的效果。方法将530例住院自然分娩初产妇,随机分为观察组和对照组。对照组实施常规产后健康教育指导,观察组由专业助产士实施8周以上一对一的健康教育及盆底肌功能训练指导。分别于产后3、6及12个月随访,通过对两组排尿状况、盆底肌张力及尿垫试验进行评估,评价PFMT对产后压力性尿失禁的防治效果。结果观察组产后3、6、12个月排尿状况评分、盆底肌张力强度评分与对照组比较,差异有统计学意义(P<0.001),产后6、12个月尿垫试验阳性率与对照组比较,差异有统计学意义(P<0.05)。结论产后行PFMT可以有效防治产后压力性尿失禁的发生和发展。其远期效果有待进一步观察。

Objective To discuss the effect of pelvic floor muscles exercise （PFMT） for the postpartum stress urinary inconti- nence. Methods 530 hospitalized maternals for the first time in natural birth were randomly divided into trial group and control group. The control group implemented health education in conventional postpartum guidance. The observation group implemented the health ed- ucation and pelvic floor muscle function training guidance one-to-one by professional midwife for 8 weeks or more. In postpartum 3,6 and 12 months respectively follow-up, evaluated the postpartum PFMT stress urinary incontinence influence, through compared the uri- nation status, pelvic muscle tension and urine pad test evaluation of two groups. Results The micturition status classification,pelvic muscle tension strength score of observation group on postpartum 3,6,12 months was difference compared to the control group （P〈 0. 001 ）. In postpartum 6 and 12 months the positive urine pad test of the observation was difference significantly compared with control groups＂ （ P〈0. 05 ）. Conclusion PFMT can be effective for the prevention and control in the occurrence and development of stress uri- nary incontinence . The long-term effect need to be further observated.