产后妇女盆底肌力情况及康复效果分析

Pelvic Floor Muscle Strength Investigation and Rehabilitation Effect Analysis of Postpartum Women

目的探讨不同分娩方式对产后早期盆底功能的影响及盆底肌锻炼促进盆底肌力的效果观察。方法随机抽取2011年12至2013年5月在广州市红十字会医院分娩的产妇共202例,根据不同分娩方式分为选择性剖宫产组(65例)、阴道顺产组(86例)、低位钳产组(51例)。分别测定分娩后的盆底Ⅰ类、Ⅱ类纤维肌力及进行产后盆底康复治疗前后的肌力对比。结果比较选择性剖宫产组、阴道顺产、低位钳产组的产后Ⅰ类、Ⅱ类纤维肌力异常发生率,发现其差异有显著的统计学意义(P<0.01);3组患者产后经过生物反馈盆底肌肉锻炼治疗后,盆底Ⅰ类、Ⅱ类纤维肌力较未经过治疗的产妇增强,有显著性差异(P<0.01)。结论选择性剖宫产相对阴道分娩对盆底组织有一定的保护作用,阴道手术分娩对盆底功能的影响最大;早期开展盆底康复治疗能有效增强盆底肌力,降低妇女盆底功能障碍性疾病的发生率。

Objective To explore the influence of different delivery ways on early postpartum pelvic floor function and the effect of effect of pelvic floor muscle exercise on promoting pelvic floor muscle. Methods 202 cases of parturients delivered in Guangzhou Red Cross Hospital from December 2011 to May 2013 were randomly selected, and then they were divided into three groups according to differ-ent delivery methods：selective cesarean section group （65 cases）, vaginal delivery group （86 cases） and low forceps delivery group （51 cases） . Type I and type II fiber strength of the pelvic floor after delivery were measured and the pelvic floor muscle strength before and after rehabilitation treatment were recorded respectively. Results The abnormal rates of type I and type II fiber strength of the pelvic floor after delivery were compared among the selective cesarean section group, vaginal delivery group and low forceps delivery group, and there was significant statistical difference （P〈0.01）. Among three groups of patients after delivery, compared with the patients untreated with biofeedback pelvic muscles exercise therapy, the type I and type II fiber strength of the pelvic floor after biofeedback pelvic muscle exercise were strengthened, and there was significant difference （P〈0.01）. Conclusion Selective cesarean section can protect the pel-vic floor organs to some extent, and operative vaginal birth will bring the biggest influence on pelvic floor function. Early pelvic floor re-habilitation therapy can effectively enhance the muscle strength and reduce the incidence of female pelvic floor dysfunction.