盆底康复干预对压力性尿失禁产妇膀胱颈活动度和尿道旋转角度的影响

Effect of pelvic floor rehabilitation intervention on bladder neck mobility and urethral rotation of puerpera with postpartum stress incontinence after delivery

目的观察产妇压力性尿失禁的发生情况,以及盆底康复干预对其膀胱颈活动度及尿道旋转角度的影响。方法选取自然分娩及剖宫产产妇各100例,观察其压力性尿失禁的发生情况;并于产后6周测量产妇Valsalva动作下的膀胱颈活动度及尿道旋转角度,然后进行2周的盆底电刺激-生物反馈-盆底肌锻炼等综合康复干预,干预结束后再测量膀胱颈活动度及尿道旋转角度。结果自然分娩组的压力性尿失禁发生率明显高于剖宫产组(29.0%vs 4.0%,P<0.05)。自然分娩产妇产后6周的膀胱颈活动度和尿道旋转角度均明显大于剖宫产者(P<0.01)。两组产妇经盆底康复干预后,其膀胱颈活动度、尿道旋转角度均较明显减小(P<0.01)。结论产后实施盆底康复干预可以改善剖宫产或自然分娩产妇的产后下尿道结构,从而降低压力性尿失禁的发生。

Objective To explore the incidence of the postpartum stress incontinence in puerpera and the effect of pelvic floor rehabilitation intervention on bladder neck mobility and urethral rotation of puerpera with postpartum stress incontinence after delivery.Methods 100 cases of spontaneous labor and 100 cases of cesarean were selected to observe the incidence of stress incontinence.The bladder neck mobility and urethral rotation of puerpera under Valsalva action was measured 6 weeks after the delivery.Then,electrical stimulation - biofeedback - pelvic floor muscle training and other comprehensive rehabilitation was performed for 2 weeks,and the bladder neck mobility and urethral rotation of puerpera was measured again after the intervention.Results The Spontaneous Labor Group had the incidence of stress incontinence significantly higher than the Cesarean Group (29.0% vs 4.0%,P<0.05).The bladder neck mobility and urethral rotation of the Spontaneous Labor Group were all significantly greater than those of the Cesarean Group (P<0.01).After the pelvic floor rehabilitation intervention,both groups had the bladder neck mobility and urethral rotation significantly decreased (P<0.01).Conclusion The implementation of pelvic floor rehabilitation intervention can improve the structure of lower urinary tract after the delivery,and thus decrease the incidence of stress incontinence.