孕期功能运动联合引导式教育对分娩结局及产后腹直肌、耻骨联合分离的影响

Effect of Functional Movement Combined with Guided Education during Pregnancy on Labor Outcomes and Postpartum Separation of the Rectus Abdominis and Pubic Symphysis

目的:探究孕期功能运动联合引导式教育对分娩结局及产后腹直肌分离(Diastasis Recti Abdominis,DRA)、耻骨联合分离(Pubic Symphysis Diastasis,PSD)的影响,为临床提供参考。方法:选取2021年7月-2022年3月罗湖医院集团罗湖区妇幼保健院收治的200例单胎妊娠初产妇作为研究对象,采用随机数表法将产妇分为两组,每组各100例。对照组采用孕期常规管理,观察组在对照组基础上采用孕期功能运动联合引导式教育进行管理,比较两组产妇的产程、分娩结局、产后DRA与PSD情况、疼痛情况。结果:观察组总产程较对照组短,差异有统计学意义(t=3.950,P<0.05)。观察组剖宫产率、会阴侧切率显著低于对照组,差异有统计学意义(χ^(2)=4.310、6.082,P<0.05)。观察组产后腹白线平脐、脐上2 cm、脐上5 cm、脐下2 cm的腹直肌间距(inter-rectidistance,IRD)与耻骨联合间距均小于对照组,差异有统计学意义(t=2.752、4.881、2.479、2.290、17.623,P<0.05)。观察组产后24 h、48 h、72 h的NRS评分均低于对照组,差异有统计学意义(t=4.165、6.247、3.788,P<0.05)。结论:采用孕期功能运动联合引导式教育较孕期常规管理可显著缩短产程、提高顺产率、降低会阴侧切率、减少DRA与PSD发生情况与产后疼痛。

Objective:To investigate the effect of functional movement combined with guided education during pregnancy on la⁃bor outcome and postpartum diastasis recti abdominis(DRA)and pubic symphysis diastasis(PSD)for clinical reference.Methods:200 cases of singleton pregnancies admitted to the hospital from July 2021 to March 2022 were selected as the study population and were divided into two groups using the random number table method,with 100 cases in each group.The control group was managed with conventional management during pregnancy,and the observation group was managed with functional exercise com⁃bined with guided education during pregnancy on the basis of the control group.The labor and delivery outcomes,postpartum DRA and PSD status,and pain status were compared between the two groups.Results:The total length of labor was shorter in the obser⁃vation group than in the control group,and the difference was statistically significant(t=3.950,P<0.05).The rates of cesarean sec⁃tion and perineal scoliosis in the observation group were significantly lower than those in the control group,and the differences were statistically significant(χ^(2)=4.310,6.082,P<0.05).The inter-rectal distance(IRD)of the abdominal white line flat umbilicus,2 cm above the umbilicus,5 cm above the umbilicus and 2 cm below the umbilicus and the pubic symphysis distance were smaller in the observation group than in the control group after delivery,and the differences were statistically significant(t=2.752,4.881,2.479,2.290,17.623,P<0.05).The NRS scores at 24 h,48 h and 72 h postpartum in the observation group were lower than those in the control group,and the difference was statistically significant(t=4.165,6.247,3.788,P<0.05).Conclusion:The use of func⁃tional exercise combined with guided education during pregnancy significantly shortened the duration of labor,increased the rate of normal delivery,decreased the rate of perineal scoliosis,and reduced the incidence of DRA and PSD and postpartum pain com⁃pared with conventional management during pregnancy.