【摘要】 目的探讨持续盆底肌锻炼指导对盆底功能障碍孕妇分娩结局及产后并发症的影响,以期为盆底功能障碍孕妇的综合干预提供参考。方法选择2017年1—8月我院收治的盆底功能障碍孕妇112例作为研究对象,所有孕妇均按照入组顺序编号,采用数字随机表法等分为对照组和研究组。两组孕妇均按照孕期保健检查规范行围产期干预,研究组在此基础上对孕妇进行围产期持续盆底肌锻炼指导和督促。比较两组孕妇妊娠结局(阴道分娩、剖宫产、阴道助产、阴道分娩孕妇第二产程时间、阴道分娩会阴侧切、阴道分娩肩难产、阴道分娩新生儿窒息)、产后6个月盆底肌力分级情况及产后并发症发生情况(产后出血、产褥感染、压力性尿失禁等)。结果产后6个月,研究组孕妇盆底Ⅰ类、Ⅱ类纤维肌力Ⅲ级及以上比例明显高于对照组(P <0. 05)。研究组孕妇阴道分娩率明显高于对照组(P <0. 05),阴道分娩孕妇阴道助产率、会阴侧切率、第二产程时间、新生儿窒息率均明显低于对照组(P <0. 05),两组孕妇阴道分娩肩难产率比较差异无统计学意义(P> 0. 05)。产后6个月,研究组孕妇压力性尿失禁发生情况明显低于对照组(P <0. 05),两组患者盆腔器官脱垂、产后出血、产褥感染及尿潴留发生情况比较差异无统计学意义(P> 0. 05)。结论持续指导盆底功能障碍孕妇行盆底肌锻炼,可有效提升孕妇及新生儿妊娠结局质量,降低产后孕妇压力性尿失禁发生率,对提升母婴健康水平具有较高的临床价值。更多还原

【Abstract】 Objective To explore the effect of continuous guidance for pelvic floor muscle exercise on the outcome of delivery and postpartum complications in pregnant women with pelvic floor dysfunction,thus providing reference for the comprehensive intervention for the pregnant women with pelvic floor dysfunction. Methods A total of 112 pregnant women with pelvic floor dysfunction admitted to our hospital from January 2017 to August 2017 were selected as the study subjects. All of them were numbered according to the order of enrollment to the group,and were divided into control group and study group with the same number of patients by numerical random table method. Both groups of pregnant women received perinatal intervention according to the standard of pregnancy health check. On the basis of this,the study group was given continuous guidance and supervision for perinatal pelvic floor muscle exercise. The pregnancy outcomes of the two groups of pregnant women( including vaginal delivery,cesarean section,vaginal midwifery,second stage of labor among vaginal delivery,perineal cut of vaginal delivery,shoulder dystocia of vaginal delivery and neonatal asphyxia of vaginal delivery),postpartum pelvic floor muscle force grading after 6 months of delivery and postpartum complications( including postpartum hemorrhage,puerperal infection,stress urinary incontinence,etc.) were compared. Results At 6 months after labor,the proportion of pelvic floor I and II fiber muscle strength,III and grades above in the study group were significantly higher than that in the control group( P < 0. 05). The vaginal delivery rate of the pregnant women in the study group was significantly higher than that of the control group( P < 0. 05). The vaginal delivery rate,the perineal cut rate,the second stage of labor,and the neonatal asphyxia rate of patients with the vaginal delivery in the study group were significantly lower than that in the control group( P < 0. 05). There was no significant statistical difference between the comparison of shoulder dystocia of vaginal delivery in the two groups( P > 0. 05). After 6 months of labor,the incidence of stress urinary incontinence in the study group was significantly lower than that in the control group( P < 0. 05). There was no significant statistical difference between the comparison of the incidence of pelvic organ prolapse,postpartum hemorrhage,puerperal infection and urinary retention between the two groups( P > 0. 05). Conclusion Continuous guidance for pelvic floor muscle exercises in pregnant women with pelvic floor dysfunction can improve the quality of pregnancy outcomes in pregnant women and neonates effectively. Meanwhile,it can reduce the incidence of stress urinary incontinence in postpartum women. Consequently,the method has a high clinical value for improving maternal and child health.更多还原