自然分娩产后盆底功能障碍产妇康复锻炼依从性的影响因素分析

Investigation of rehabilitation exercise compliance in parturients with pelvic floor dysfunction after natural childbirth

目的:分析自然分娩产后盆底功能障碍(PFD)产妇康复锻炼依从性的影响因素,为产妇产后康复提供理论依据。方法:选取2020年6月—2023年6月于聊城市第二人民医院产科自然分娩且产后42d复查的1220例产妇。采用一般资料调查表、盆底肌训练依从性问卷进行调查,并进行盆底功能检测。依据PFD产妇依从性得分将其分为依从性良好组(得分≥15分)和依从性差组(得分<15分)。采用单因素分析、Logistic回归分析对PFD产妇依从性影响因素进行分析。结果:1220例产妇中,发生PFD 763例(62.54%);763例PFD产妇中,盆底肌训练依从性良好者390例,依从性差者373例。两组孕次、产次、文化程度、职业性质、盆底功能恢复情况比较,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,孕次、产次、文化程度、职业性质是PFD产妇康复锻炼依从性的影响因素(P<0.05)。结论:自然分娩且产后42d复查的产妇产后PFD发生率较高,且孕次和产次较多、文化程度较低、从事体力劳动的PFD产妇盆底康复锻炼的依从性较差。故为了提高这些产妇产后康复锻炼的依从性,应加强健康教育、提供专业指导、制订个性化计划和心理支持等,以提高产妇对盆底康复的认识,降低产后PFD的发生率,从而提高产妇的生活质量。

Objective To analyze the postpartum pelvic floor dysfunction(PFD)and the compliance of pelvic floor rehabilitation exercise in natural parturients,and provide theoretical basis for postpartum rehabilitation of parturients.Methods A total of 1220 parturients of natural delivery and postnatal review in the obstetrics department of Liaocheng Second People's Hospital from June 2020 to June 2023 were selected as the research objects.The general data questionnaire and the pelvic floor muscle training compliance questionnaire were used to investigate the pelvic floor function.According to the compliance score of PFD mothers,they were divided into good compliance group(score≥15)and poor compliance group(score<15).Univariate analysis and Logistic regression analysis were used to analyze the influencing factors of compliance of PFD parturients.Results Among 1220 parturients,763(62.54%)developed PFD.Among 763 PFD,390 had good compliance with pelvic floor muscle training and 373 had poor compliance.There were statistically significant differences in pregnancy,childbirth,education,occupational nature and pelvic floor function recovery between the two groups(P<0.05).Logistic regression analysis showed that pregnancy time,birth time,education level and occupational nature were the influencing factors of compliance with rehabilitation exercise for PFD parturients(P<0.05).Conclusions The incidence of PFD is higher in women with natural delivery and 42 d postnatal review,and the compliance of PFD women with more pregnancies and deliveries,lower education level and physical labor was poor.Therefore,in order to improve the compliance of postpartum rehabilitation exercise of these parturients,health education,professional guidance,personalized plans and psychological support should be strengthened to improve parturients'awareness of pelvic floor rehabilitation,reduce the incidence of postpartum PFD,and thus improve the quality of life of parturients.