产钳助产和自然分娩经康复治疗后盆底肌恢复的效果观察

Effect observation of rehabilitation on pelvic floor muscle recovery after forceps delivery and spontaneous labor

目的：探讨产钳助产和自然分娩经康复治疗后盆底肌恢复的效果。方法选择2011年5月~2013年8月在本院分娩的150例初产妇，按生产方式分为产钳助产组（n=78）和自然分娩组（n=72），所有产妇均于产后第2天开始由专人指导进行Kegel训练，至产后42 d，根据盆底肌力的恢复情况选择阴道哑铃或电刺激＋生物反馈进行盆底肌康复治疗，3个月为1疗程。比较两组产妇产后42 d及康复治疗结束后的盆底肌力、尿失禁发生率及性生活质量恢复情况。结果经过早期康复治疗后，两组产妇的盆底肌功能明显增强、性生活满意度显著升高，与产后42 d比较，差异有统计学意义（P〈0.05），但两组间进行比较，差异无统计学意义（P〉0.05）。结论产后早期盆底肌康复治疗能够明显增强盆底肌的功能，使产钳助产产妇恢复到与自然分娩产妇无明显区别，而且还能消除夫妻对产钳助产导致会阴撕裂伤而影响性生活质量的思想顾虑，提高产钳助产的依从性和顺产率，提高生活质量，促进家庭和谐，值得临床推广。

Objective To observe the effect of rehabilitation on pelvic floor muscle recovery after forceps delivery and spontaneous labor. Methods 150 cases of primiparae delivered in our hospital from May 2011 to August 2013 were se-lected, and they were divided into forceps delivery group（n=78） and spontaneous labor group（n=72） by production mode. All participants were guided for Kegel training by specially-assigned persons in the second day after delivery,according to muscle strength recovery of pelvic floor,vaginal dumbbell or electrical stimulation with biological feedback was se-lected aiming at rehabilitation of pelvic floor muscle in 42 days after childbirth,1 course of treatment lasted 3 months. Muscle strength of pelvic floor, incidence of urinary incontinence and quality of sexual life at 42 days after childbirth and termination of rehabilitation training between two groups was compared. Results After early rehabilitation,pelvic floor muscle function muscle function,sexual satisfaction significantly higher of two groups.There was a statistical differ-ence in spontaneous recovery of pelvic floor muscle function before and after training in both groups （P〈0.05）. After early period rehabilitation training, there was no significant difference （P〉0.05）. Conclusion Pelvic floor muscle train-ing at an early stage after delivery can significantly strengthen pelvic floor muscle’s function and display no obvious difference in comparison with that in puerperae by spontaneous labor, which increases compliance of forceps delivery in these pregnant women, eliminates couple’s misgivings that forceps delivery has some influences on sexual life, improve quality of life, and promotes family harmony. Early-stage pelvic floor muscle training after delivery is worthy of expan-sion in clinic.