489例产后腹直肌分离产妇患病现状及影响因素分析

Current Status of Postpartum Diastasis Recti Abdominis and Its Influence Factors:A 489-case Study

目的了解产后6~8周产妇腹直肌分离的患病现状,分析其影响因素。方法采用便利抽样法,选取2020年7月—2021年1月于山东省某三级甲等医院产后康复门诊就诊的产妇489例作为研究对象,采用问卷调查法收集产妇的一般资料,采用Glazer评估法测量产妇的盆底肌电值,采用指测法测量产妇腹直肌分离的程度,采用二元Logistic回归分析产后腹直肌分离发生的主要影响因素。结果本组产妇产后腹直肌分离的患病率为61.6%(301/489),其中轻度占比74.8%(225/301),中度占比21.5%(65/301),重度占比3.7%(11/301)。产妇年龄较大、经产分娩、混合喂养及新生儿体质量较高是产后腹直肌分离的独立危险因素(P<0.05)。结论产后腹直肌分离的患病率较高,应重点关注年龄较大、经产分娩、混合喂养及新生儿体质量较高的产妇腹直肌分离的情况。医护人员也应对腹直肌分离引起重视,在围产期采取针对性的预防及干预措施,减轻产后腹直肌分离的发生及发展。

Objective To investigate the current status of postpartumdiastasis recti abdominis(DRA)in puerpera 6-8 weeks after childbirth and analyze its influencing factors.Methods Convenience sampling method was used to collect 489 puerpera as the research objects in the postpartum rehabilitation clinic of a tertiary grade-A hospital in Shandong Province from July 2020 to January 2021.General data of puerpera were collected by questionnaire survey.Pelvic floor EMG value of puerpera was measured by Glazer evaluation,and DRA was assessed by palpation using finger breaths.Binary logistic regression was used to analyze the main influencing factors of postpartum DRA.Results The prevalence of postpartum DRA was 61.6%(301/489),including 225 mild cases,accounting for 74.8%(225/301),65moderate ones for 21.5%(65/301),and 11 severe ones for 3.7%(11/301).Older maternal age,vaginal delivery,mixed feeding and higher neonatal body weight were independent risk factors for postpartum DRA(P<0.05).Conclusion The prevalence of postpartum DRA is high,and more attention should be paid to factors such as older maternal age,vaginal delivery,mixed feeding and newborns with high body weight.Medical staff should pay attention to DRA and take targeted prevention and intervention measures in perinatal period to reduce the occurrence and development of DRA after delivery.