不同康复训练方式对阴道分娩产妇盆底功能障碍性疾病的影响研究

Influence of Different Rehabilitation Training Methods on Pelvic Floor Dysfunction of Parturients in Vaginal Delivery

目的探讨不同康复训练方式对阴道分娩产妇盆底功能障碍性疾病的影响。方法选取2021年5月—2023年10月麻城市人民医院收治的143例初产妇作为研究对象,根据干预方案不同分为训练干预组(86例)和对照组(57例)。对照组给予产后42 d健康教育联合凯格尔运动治疗,干预组给予训练产后42 d健康教育联合凯格尔运动和盆底康复训练。对比两组盆腔器官脱垂、尿失禁发生情况、盆底肌力分级情况和盆底超声检查指标。结果训练干预组盆腔器官脱垂率为10.53%,显著低于对照组的25.58%,差异有统计学意义(χ^(2)=4.934,P<0.05)。训练干预组尿失禁率为21.05%,显著低于对照组的40.70%,差异有统计学意义(χ^(2)=5.996,P<0.05)。治疗后,训练干预组盆底肌力分级情况优于对照组,差异有统计学意义(P<0.05)。治疗后,两组不同状态下肛提肌裂孔前后径、左右径以及面积小于治疗前,且训练干预组小于对照组,差异有统计学意义(P均<0.05)。结论产后盆底康复训练有助于改善经阴道分娩产妇盆底肌力和盆底结构。

Objective To explore the influence of different rehabilitation training methods on pelvic floor dysfunction of parturients in vaginal delivery.Methods A total of 143 cases of primipara in Macheng People's Hospital from May 2021 to October 2023 were selected as the study objects and divided into the training intervention group(86 cases)and the control group(57 cases)according to different intervention programs.The control group was given 42 days postpartum health education combined with Kegel exercise therapy,and the training intervention group was given 42 days postpartum health education combined with Kegel exercise and pelvic floor rehabilitation training.The incidence of pelvic organ prolapse,urinary incontinence,pelvic floor muscle strength grading and pelvic floor ultrasound were compared between the two groups.Results The rate of pelvic organ prolapse in the training intervention group was 10.53%,significantly lower than that in the control group 25.58%,and the difference was statistically significant(χ^(2)=4.934,P<0.05).The urinary incontinence rate in the training intervention group was 21.05%,significantly lower than that in the control group 40.70%,and the difference was statistically significant(χ^(2)=5.996,P<0.05).After treatment,the classification of pelvic floor muscle strength in the training intervention group was better than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the anterior and posterior diameters,left and right diameters and area of the levator anal hiatus in different states of the two groups were smaller than be⁃fore treatment,and the training intervention group were smaller than the control group,and the difference was statistically significant(all P<0.05).Conclusion Postpartum pelvic floor rehabilitation training is helpful to improve the pelvic floor muscle strength and pelvic floor structure.