孕期Kegel锻炼对预防产后盆底功能障碍的作用

Effect of Kegel Exercise during Pregnancy on Prevention of Postpartum Pelvic Floor Dysfunction

目的探讨孕期Kegel锻炼对预防产后盆底功能障碍的作用。方法选取2019年6月—2022年8月在扬州市妇幼保健院医院规律产检、分娩,并愿意行凯格尔锻炼的经产妇250名,根据锻炼情况将其分为经常锻炼组80名、偶尔锻炼组109名、无锻炼组61名,比较3组尿失禁问卷表简表(ICI-Q-SF)评分与产后Ⅰ类、Ⅱ类肌纤维肌力及盆腔器官脱垂量化分期(POP-Q)。结果经常锻炼组产后3 d、6~12周ICI-Q-SF评分分别为(8.34±1.86)分、(3.67±1.14)分,均低于偶尔锻炼组、无锻炼组,差异有统计学意义(t=4.030、4.172、7.520、9.332,P<0.05)。产后6~12周经常锻炼组Ⅰ类肌纤维肌力≥3级82.50%,Ⅱ类肌纤维肌力≥3级96.25%,均优于偶尔锻炼组与无锻炼组,差异有统计学意义(χ^(2)=72.008、43.782、76.436、110.272,P<0.05)。经常锻炼组阴道前壁、后壁、前穹窿或宫颈POP-Q分度0度率35.00%、86.25%、90.00%,均高于偶尔锻炼组、无锻炼组,差异有统计学意义(χ^(2)=10.667、5.152、4.738、15.959、22.740、30.704,P<0.05)。结论孕期Kegel锻炼能减轻产后尿失禁,可提高盆底肌力,有利于预防盆腔器官脱垂。

Objective To investigate the effect of Kegel exercise during pregnancy on prevention of postpartum pelvic floor dysfunction.Methods 250 pregnant women who were regularly examined and delivered in Yangzhou Maternal and Child Health Hospital from June 2019 to August 2022 were selected and were willing to take Kegel exercise.They were divided into regular exercise group(80 women),occasional exercise group(109 women)and no exercise group(61 women)according to the exercise situation.Compare the score of the 3 groups of urinary incontinence questionnaire(ICI-Q-SF)with the quantitative stage of postpartum typeⅠand typeⅡmuscle fiber strength and pelvic organ prolapse(POP-Q).Results The ICI-Q-SF scores of the regular exercise group were(8.34±1.86)points and(3.67±1.14)points at the 3rd and 6th to 12th weeks after delivery,respectively,which were lower than those of the occasional exercise group and the non exercise group,and the difference was statistically significant(t=4.030,4.172,7.520,9.332,P<0.05).The muscle strength of classⅠmuscle fiber≥grade 382.50%and classⅡmuscle fiber≥grade 396.25%in the regular exercise group from 6 to 12 weeks after delivery were better than those of the occasional exercise group and the no exercise group,the difference was statistically significant(χ^(2)=72.008,43.782,76.436,110.272,P<0.05).The 0-degree rate of POP-Q scores of the anterior wall,posterior wall,anterior fornix or cervix of the vagina in the regular exercise group was 35.00%,86.25%and 90.00%,which were higher than those in the occasional exercise group and the no exercise group,and the difference was statistically significant(χ^(2)=10.667,5.152,4.738,15.959,22.740,30.704,P<0.05).Conclusion Kegel exercise during pregnancy can reduce postpartum urinary incontinence,improve pelvic floor muscle strength,and help prevent pelvic organ prolapse.