早期盆底康复锻炼对产后会阴瘢痕疼痛的影响

Effects of Early Pelvic Floor Rehabilitation Exercises on Pain Degree for Patients with Cicatricial Contracture of Perineum

目的探讨早期盆底康复锻炼对产后会阴瘢痕疼痛的影响。方法方便收集该院86例会阴瘢痕疼痛患者,收集时间为2018年1月-2019年5月,遵循随机数字表法的分组原则,将86例患者分为对照组与观察组,每组43例,对照组单纯接受常规护理,观察组在对照组的基础上实施早期盆底康复锻炼,对比两组治疗效果及其对性生活的影响。结果干预前,两组盆底PC肌张力对比差异无统计学意义(P>0.05);治疗3个月后,两组PC肌张力Ⅰ度之间出现较大差异,其中观察组盆底PC肌张力Ⅰ度、Ⅱ度、Ⅲ度各占比3.70%、27.78%、68.52%,明显优于对照组11.32%、37.74%、49.06%,观察组Ⅰ度人数低于对照组,Ⅲ度人数高于对照组,差异有统计学意义(χ~2=4.180、7.815,P<0.05),在产后42 d时,两组产妇VAS与VSS评分对比差异无统计学意义(P>0.05),自产后3个月起至产后9个月,观察组VAS评分分别为(3.40±0.77)分、(2.50±0.68)分、(2.00±0.64)分明显低于对照组(4.53±0.78)分、(4.47±1.01)分、(3.93±0.69)分,对比差异有统计学意义(t=3.724、6.886、12.798,P<0.05)且观察组产后6个月至9个月时VSS评分分别为(5.00±0.74)分、(4.60±0.72)分同样低于对照组(6.00±0.98)分、(5.80±0.92)分,差异有统计学意义(t=9.447、8.080,P<0.05)。结论早期实施盆底康复锻炼可有效降低产后会阴瘢痕的疼痛程度,促进瘢痕软化,减轻瘢痕增生,对产后康复具有重要意义,值得在临床推广。

Objective To discuss the effects of early pelvic floor rehabilitation exercises on pain degree for patients with cicatricial contracture of perineum. Methods Convenient select The clinical data about 86 patients with cicatricial contracture of perineum was obtained,collected between January 2018 and May 2019 According to random number table, patients were assigned to two groups, 43 cases in each group. The control group took the routine nursing;on the basis of the former, the observation group took the early pelvic floor rehabilitation exercises. The clinical effect and sexual life was appraised. Results Before intervention, PC(pubococcygeus) muscular tension between groups were not statistically significantly different(P>0.05);after 3 m of treatment, the ratio of patients with PC muscular tension I for two groups was found to be statistically significant;the ratio of patients with PC muscular tension Ⅰ, Ⅱ and Ⅲ in the observation group(3.70%, 27.78%, 68.52%)was significantly better than that of control group(11.32%, 37.74%, 49.06%);the number of patients with tension Ⅰ in the observation group was smaller than that of control group;the number of patients with tension Ⅲ in the observation group was larger than that of control group(χ~2=4.180, 7.815, P<0.05);after 42 d of delivery, VAS(visual analogue scale) and VSS(Vancouver scar scale) scores between groups were not statistically significantly different(P>0.05);after 3 m-9 m of delivery,VAS scores in the observation group were(3.40 ±0.77)points,(2.50 ±0.68)points and(2.00 ±0.64)points, which were significantly lower than those of control group(4.53±0.78)points,(4.47±1.01)points,(3.93±0.69)points,the difference was statistically significant(t=3.724, 6.886, 12.798, P<0.05);after 6 m-9 m of delivery, VSS scores in the observation group were(5.00±0.74)points and(4.60±0.72)points, which were significantly lower than those of control group(6.00±0.98)points,(5.80±0.92)points,the difference was statistically significant(t=9.447, 8.080, P<0.05). Conclusion The early pelvic floor rehabilitation exercises can efficiently reduce the pain degree, soften the cicatrix, relieve the scar hypertrophy and promote the postpartum rehabilitation. It is worthy of clinical promotion.