不同盆底康复时机对高龄产妇产后PFD盆底功能恢复的影响

Effects of different timing of pelvic fl oor rehabilitation on pelvic fl oor function recovery in elderly parturient women with postpartum PFD

目的 分析不同盆底康复时机对高龄产妇产后PFD盆底功能恢复的影响。方法 选取2018年4月至2020年12月在广东省佛山复星禅诚医院进行分娩的187例高龄产妇为研究对象,均在产后6周复查诊断盆底功能障碍(PFD)后进行治疗,依据产后治疗时间不同分为观察组(产后6~8周治疗,n=98)、对照组(产后9~11周治疗,n=89),对比其治疗前后盆底肌力、Glazer盆底表面肌电参数、盆底功能相关参数、PFD恢复情况。结果 观察组治疗后Ⅰ类肌纤维持续收缩压、持续时间及Ⅱ类肌纤维快速收缩压、收缩个数高于对照组(P <0.05);治疗后观察组BSD-S高于对照组,而UVJ-M、PUVA-S、PUVA-R、BND、BSD-R低于对照组(P<0.05);观察组治疗1疗程后快肌阶段最大值、慢肌阶段平均值、耐力测试阶段平均值、总得分均高于对照组(P <0.05);观察组SUI、盆腔脏器脱垂等的发生比例均较对照组低,差异有显著性(P <0.05);观察组产后6个月躯体状态、精神状态、性生活满意度高于对照组(P <0.05)。结论 产后早期(6~8周)开展盆底康复训练有利于改善高龄产妇产后盆底肌力,促进产后PFD盆底功能恢复,提高女性生活质量,值得在临床推广实践。

Objective To analyze the effects of different timing of pelvic fl oor rehabilitation on pelvic fl oor function recovery in elderly parturient women with postpartum pelvic floor dysfunction(PFD).Methods A total of 187 elderly parturient women who gave birth in Foshan Fosun Chancheng Hospital between April 2018 and December 2020 were selected as the research subjects.All were diagnosed with PFD at 6 weeks after delivery.They were divided into observation group(postpartum 6-8 weeks,n = 98) and control group(postpartum 9-11 weeks,n = 89) according to the timing of postpartum pelvic fl oor rehabilitation therapy.The pelvic fl oor muscle strength,Glazer pelvic fl oor surface electromyography parameters,pelvic fl oor function related parameters,and recovery from PFD were compared between the two groups.Results After treatment,the sustained systolic pressure and duration of type Ⅰ muscle fibers,rapid systolic pressure and number of type Ⅱ muscle fi bers in the observation group were higher/longer/larger than those in the control group with signifi cant difference(P <0.05).After treatment,the BSD-S of observation group was larger than that of the control group,while UVJ-M,PUVA-S,PUVA-R,BND,and BSD-R were smaller than those in the control group(P < 0.05).The maximum value of fast muscle phase,mean value of slow muscle phase,mean value of endurance test phase and total score of the observation group after 1 course of treatment were higher than those of the control group(P < 0.05).The incidence rates of SUI,pelvic organ prolapse in the observation group were lower than those in the control group(P < 0.05).Parturient women in the observation group were more satisfi ed with their physical state,mental state,and sexual satisfaction than the control group at 6 months after delivery(P < 0.05).Conclusion Pelvic fl oor rehabilitation training in early postpartum period(6-8 weeks) is benefi cial to improve postpartum pelvic fl oor muscle strength of elderly parturient women with postpartum PFD,promote the recovery of pelvic fl oor function,and improve their quality of life.