基于跨理论模型的产后康复护理在盆底功能障碍患者中的应用效果

Application effect of postpartum rehabilitation nursing based on transtheoretical model in patients with pelvic floor dysfunction

目的探讨基于跨理论模型(TTM)的产后康复护理在盆底功能障碍(PFD)患者中的应用效果,以期为临床进行有效的盆底功能训练提供依据。方法以2020年1月至2021年12月福州市第二医院收治的76例PFD患者为研究对象,按照随机数字表法将其分为2组,每组38例。对照组患者予以常规康复训练及治疗,观察组患者在对照组干预方法的基础上予以基于TTM的产后康复护理。比较2组患者的盆底肌肌力、盆底组织状态、尿失禁程度及康复训练依从性。结果干预3个月后,观察组的盆底肌肌力和康复训练依从性均优于对照组(P均<0.05)。干预3个月后,2组的膀胱颈旋转角、压力状态下尿道膀胱后角和静息状态下尿道膀胱后角均小于干预前(P均<0.05),且观察组均小于对照组(P均<0.05)。干预3个月后,观察组的尿失禁程度轻于对照组(P<0.05)。结论将基于TTM的产后康复护理应用于PFD患者,可提高其康复训练依从性和盆底肌肌力,改善其盆底组织状态和尿失禁程度。

Objective To investigate the application effect of postpartum rehabilitation nursing based on the transtheoretical model(TTM)in patients with pelvic floor dysfunction(PFD),and to provide a basis for effective training in the pelvic floor function.Methods A total of 76 PFD patients admitted to Fuzhou Second Hospital from January 2020 to December 2021 were enrolled.They were divided into two groups via random number table method,with 38 cases in each group.The control group was given conventional rehabilitation training and treatment,while the observation group was given TTM-based postpartum rehabilitation nursing in addition to the intervention method of the control group.The pelvic floor muscle strength,pelvic floor status,degree of urinary incontinence,and compliance with rehabilitation training were compared between the two groups.Results After 3 months of intervention,the pelvic floor muscle strength and compliance with rehabilitation training in the observation group were better than those in the control group(both P<0.05).After 3 months of intervention,the bladder neck rotation angle,posterior urethrovesical angle on straining,and posterior urethrovesical angle at rest in both groups were smaller than those before the intervention(all P<0.05),and the parameters in the observation group were smaller than those in the control group(all P<0.05).After 3 months of intervention,the degree of urinary incontinence in the observation group was better than that in the control group(P<0.05).Conclusion The application of the TTM-based postpartum rehabilitation nursing in patients with PFD can improve their compliance with rehabilitation training,increase their pelvic floor muscle strength,and improve their pelvic floor tissue status and degree of urinary incontinence.