盆底肌锻炼持续性指导对孕妇焦虑抑郁情绪和分娩结局的影响

Study on the Influence Of Persistent Pelvic Floor Muscle Exercise Guidance on Anxiety and Depression and Delivery Outcome in Pregnant Women

目的探究并分析盆底肌锻炼持续性指导对孕妇焦虑抑郁情绪和分娩结局的影响。方法选择2012年1月至2013年1月在深圳市南山妇幼保健院产科定期产检并分娩的100例孕妇为研究对象。应用随机数字表法将孕妇分为常规指导组和持续指导组,每组50例。常规指导组患者接受常规产科盆底肌锻炼指导,持续指导组接受盆底肌锻炼持续性指导,从入组直至胎儿出生,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)对孕妇焦虑抑郁情绪和分娩结局资料进行收集,并分析两组孕妇焦虑抑郁情绪和分娩结局。结果出院时,常规指导组产妇深Ⅰ、浅Ⅰ、深Ⅱ、浅Ⅱ层盆底肌力均低于持续指导组,差异有统计学意义[(3.42±0.98)分比(4.21±0.81)分,(3.21±1.08)分比(4.16±0.73)分,(3.54±0.91)分比(4.26±0.64),(3.47±0.82)分比(4.19±0.68)分,P<0.05]。持续指导组SAS标准分、SDS标准分、产妇并发症、剖宫产率显著低于常规指导组[(41.28±2.91)分比(46.27±3.24)分,(42.27±2.75)分比(47.19±2.86)分,4%比20%,8%比26%),P<0.05]。持续指导组阴道分娩率显著高于常规指导组(86%比62%,P<0.05),常规指导组和持续指导组围生儿结局差异无统计学意义(20%比12%,χ2=1.190,P>0.05)。结论盆底肌锻炼持续性指导能够明显改善孕妇焦虑抑郁情绪、分娩方式和孕妇结局。

Objective To investigate the influence of persistent pelvic floor muscle exercise guidance on anxiety and depression and delivery outcome in pregnant women in order to provide reference basis for the optimization of antenatal care. Methods One hundred cases of pregnant women who accepted regular ante- natal examination and finally delivered in Department of Obstetrics, Shenzhen Nanshan Women and Children Health Care Hospital from Jan. 2012 to Jan. 2013 were selected as research objects, and divided into routine guidance group and continuous guidance group according to random number table, with 50 cases in each group. Patients in routine guidance group accepted routine pelvic floor muscle exercise guidance, while patients in continuous guidance group received persistent pelvic floor muscle exercise guidance. From the beginning of the research to the time of fetuses＇ birth,the anxiety and depression and delivery outcome in pregnant women of the two groups were evaluated and analyzed hy anxiety self-assessment scale（SAS） and depression self-assessment scale（SDS）. Results The pelvic floor muscle strengths of deep I , shallow I , deep lI and shallow II floors of patients in continuous guidance group pregnant women were superior to those of the routine guidance group [ （ 3.42 ± 0. 98,3.21 ± 1.08,3.54 ± 0. 91,3.47 ± 0. 82 ） vs （ 4. 21 ± 0. 81,4. 16 ±0. 73,4. 26±0. 64,4. 19 ±0. 68）,P 〈0. 05] at hospital discharge,the differences were sta- tistically significant. The SAS scores, SDSscores, maternal complications and cesarean section rates of the con- tinuous guidance group were significantly lower than those of the routine guidance group[ （41.28 ± 2. 91, 42. 27 ± 2.75,4% ,8% ） vs （46. 27 ± 3.24,47. 19 ± 2. 86,20% ,26% ） ,P 〈 0. 05 ]. Vaginal delivery rate of the continuous guidance group was significantly higher than the routine guidance group（86% vs 62% ,P 〈 0. 05 ）. There were no statistically significant difference of perinatal outcome between the two groups（20% vs 12%, X2 = 1. 190,P 〉 0. 05 ）. Conclusion The persistent pelvic floor muscle exercise guidance can signifi- cantly reduce the degree of anxiety and depression in pregnant women, and impreve the delivery mode and pregnant outcome.