盆底肌锻炼定期随访对分娩结局和盆底肌恢复的影响

Effect of regular follow-up of pelvic floor muscle training on delivery outcome and recovery of pelvic muscle strength

目的观察分析盆底肌锻炼定期随访指导对分娩结局和盆底肌恢复的影响。方法选取2013年3月-2015年1月来该院产科门诊进行定期产检的健康孕妇,分为观察组和对照组。对照组由1名专职护士教授盆底肌锻炼课程,自行在家进行盆底肌锻炼;观察组在此基础上给予定期登门随访指导。结果两组在剖宫产率方面,差异无统计学意义(P>0.05);观察组平均第二产程短于对照组,差异有统计学意义(P<0.05);顺产时会阴裂伤率和会阴侧切率观察组均低于对照组(均P<0.05);产后6周、3个月时盆底肌手测评分观察组均优于对照组(均P<0.05);观察组产前及产后夜尿和尿失禁发生率均低于对照组(均P<0.05)。结论定期登门随访指导盆底肌锻炼有助于缩短第二产程、降低顺产时会阴裂伤率和会阴侧切率,有助于产后盆底肌力的恢复和降低产前及产后夜尿和尿失禁发生率。

Objective To observe and analyze the effect of regular follow-up and guidance of pelvic floor muscle training （PFMT） on delivery outcome and recovery of pelvic muscle strength. Methods Healthy pregnant women receiving regular prenatal examination in Outpatient of Obstetrics in the hospital fi＇om March 2013 to January 2015 were selected and divided into observation group and control group. The women in control group received PFMT instructed by a full-time nurse, then they took PFMT by themselves in home; the women in observation group were visited and guided regularly based on control group. Results There was no statistically significant difference in cesarean section rate between the two groups （P〉0.05） ; the duration of the second stage of labor in observation group was statistically significantly shorter than that in control group （P〈0. 05 ） ; the rates of perineal laceration and episiotomy during vaginal delivery in observation group were statistically significantly lower than those in control group （ P〈0. 05 ） ; pelvic muscle strength scores after six weeks and three months of delivery in observation group were statistically significantly better than those in control group （ P〈0. 05） ; the incidence rates of nocturia and urinary incontinence before aud after delivery in observation group were statistically significantly lower than those in control group （ P〈0. 05 ） . Conclusion Regular follow-up and guidance of PFMT for the pregnant and postpartum women can shorten the second labor stage and reduce the incidence rates of perineal laceration and episiotomy, which is helpful in recovery of postpartum pelvic floor muscle strength and reducing the incidence rates of nocturia and urinaryincontinence before and after delivery.