农村女性产后盆底康复治疗的临床观察

摘要

Objective To investigate the appropriate approach of pelvic floor rehabilitative management in postpartum rural female patients.Methods A total of 160 rural primiparas by vaginal delivery were randomly divided into therapy group (n =80)and control group (n =80).The therapy group was given Kegel training and vaginal dumbbell treatment,while control group received electrical stimnlation combined with biofeedback treatment.Incidences of comprehensive muscle strength of pelvic floor,pelvic organ prolapse and urinary incontinence of the two groups were followed up and compared for 3 months and 6 months aftrr treatment.Results A total of 10 rural primiparas (12.5％) in therapy group failed to continue treatment,and 37 rural primiparas (46.3％) in control group failed to continue treatment.The recovery of comprehensive muscle strength of pelvic floor in two groups after 3 months of treatment were significantly different (P ＜0.05) ; the differences in incidences of pelvic organ prolapse and urinary incontinence were not statistically significant (P ＞ 0.05).The incidences of comprehensive muscle strength of pelvic floor,pelvic organ prolapse and urinary incontinence in two groups after 6 months of treatment showed significant differences compared with those before treatment (P ＜0.05).The incidences of comprehensive muscle strength of pelvic floor in two groups after 6 months of treatment were significantly better than those after 3 months of treatment (P ＜0.05).Conclusion Kegel training and vaginal dumbbell treatment may improve the postpartum function of pelvic floor as an ideal method for pelvic floor rehabilitative management in postpartum rural female patients.%目的 探讨农村女性产后盆底康复治疗的理想方法.方法 选择我院经阴道分娩农村初产妇160例,随机分为观察组和对照组,每组80例.观察组予Kegel训练加阴道哑铃治疗,对照组予电刺激联合生物反馈治疗,均于治疗3个月和6个月后随访并比较盆底综合肌力恢复情况、盆腔脏器脱垂及尿失禁发生率.结果 观察组10例(12.5％)未能坚持治疗,对照组37例(46.3％)未坚持治疗.两组治疗3个月后与治疗前比较,盆底综合肌力恢复情况差异有统计学意义(P＜0.05)；盆腔脏器脱垂发生率及尿失禁发生率差异无统计学意义(P＞0.05).两组治疗6个月后分别与治疗前比较,盆底综合肌力恢复情况、盆腔脏器脱垂发生率及尿失禁发生率差异均有统计学意义(P＜0.05).两组治疗6个月时盆底综合肌力恢复情况优于治疗3个月后,差异有统计学意义(P＜0.05).结论 Kegel训练加阴道哑铃治疗能显著改善产后盆底功能,且操作简单、成本低廉,是广大农村女性产后盆底康复的理想方法.