不同时机产后盆底康复治疗对尿失禁和性生活质量的影响

Impact of different timing of pelvic floor rehabilitation on urinary incontinence and the quality of sex life

目的:探讨不同时机开展产后盆底康复治疗对产妇盆底功能障碍患者尿失禁和性生活质量的影响及应用价值。方法:将在临海市妇幼保健院妇治疗的产妇盆底功能障碍患者120例根据开展产后盆底康复治疗时间分为A、B两组,其中A组在产后42-56d开展治疗,B组在产后57-70d开展治疗,对比两组治疗效果。结果:A组干预后阴道肌张力(138.97±15.66)cm H_2O,阴道肌电压(24.97±4.57)μV,夜尿次数(0.72±0.16)次;B组干预后阴道肌张力(137.64±15.71)cm H_2O,阴道肌电压(24.88±4.62)μV,夜尿次数(0.74±0.15)次,组间对比,差异无统计学意义(P>0.05)。A组发生子宫脱垂0例,膀胱脱垂2例,直肠脱垂1例,尿失禁2例,性生活质量评分(9.35±0.21)分;B组发生子宫脱垂1例,膀胱脱垂1例,直肠脱垂2例,尿失禁3例,性生活质量评分(9.41±0.19)分,组间差异无统计学意义(P>0.05)。结论:产后早期不同阶段开展盆底康复治疗均可以提升给患者盆底肌力并改善患者盆底功能,能够有效减少尿失禁发生、提升性生活质量,临床应当根据实际情况在产后早期不同时机开展积极的盆底康复治疗。

Objective： To explore the influence and application value of postpartum rehabilitation therapy on urinary incontinence and quality of sexual life of patients with pelvic floor dysfunction. Methods： 120 patients with maternal pelvic floor dysfunction were selected and according to the different timing of postpartum pelvic floor rehabilitation were divided into group A and group B. Group A received treatment on postpartum 42-56 d while group B on postpartum 57 ~ 70 d. The therapeutic effect in the two groups were compared. Results： The vaginalmuscle tone,the vagina muscle voltage and the number of night urine in group A were（ 138. 97 ± 15. 66） cm H_2O,（ 24. 97 ± 4. 57） μV and（ 0. 72 ± 0. 16） respectively,while those in group B were（ 137. 64 ± 15. 71） cm H_2O,（ 24. 88 ± 4. 62） μV and（ 0. 74 ± 0. 15） respectively,without statistically significant differences between the two groups（ P 〉0. 05）. In group A,there were 0 case of prolapse of uterus,2 cases of bladder prolapse,a case of rectal prolapse and 2 cases of urinary incontinence,and the scores of quality of sexual life were（ 9. 35 ± 0. 21） points.In group B,there was a case of prolapse of uterus,a case of bladder prolapse,2 cases of rectal prolapse and 3 cases of urinary incontinence,and the scores of quality of sexual life were（ 9. 41 ± 0. 19） points. There was of no statistically significant differences between the two groups（ P〉 0. 05）. Conclusions： Postpartum pelvic floor rehabilitation is conductive to improving the pelvic floor muscle strength,reducing urinary incontinence and improving the quality of sexual life. Therefore,postpartum pelvic floor rehabilitation should be conducted at different timing according to the special condition of patients.