妊娠和产后盆底肌功能锻炼对盆底肌和排尿功能的影响

摘要

目的：探讨妊娠和产后盆底肌锻炼对盆底肌活力和排尿功能的影响。方法将97例孕妇随机分成训练组58例及对照组39例两组,采用阴道测压计测定盆底肌强度,通过测定尿流率和3 d 的排尿日志判定排尿功能；通过 UDI-6、IIQ-7和 OAB-q 问卷调查泌尿系统功能。结果产后6~8周训练组的盆底肌强度明显高于对照组(t =12.09,P =0.003)；训练组在产后6~8周的最大尿流率和平均尿流率与对照组相比差异显著(P <0.05)；训练组在产后6~8周尿急状况与对照组相比明显改善(P <0.05)；产后6~8周 UDI-6和 OAB-q 评分明显恢复；孕期28周、孕期36~38周和产后6~8周训练组 IIQ-7与对照组相比差异性显著(t =5.06,P =0.029；t =6.08,P =0009；t =16.88,P <0.001)。结论妊娠和分娩影响盆底肌强度、泌尿系统症状、女性生活质量以及排尿功能。妊娠和产后期间的盆底肌锻炼可提高盆底肌强度、避免泌尿系统症状的进一步加重,进而提高女性的生活质量。%Objective To investigate the effect of pelvic floor muscle training on pelvic floor muscle activities and voiding functions in the pregnancy and postpartum period. Methods 97 cases of pregnant women were randomly assigned into the training group(n = 58)and those inpregnancy(n = 39). The strength of pelvic floor muscle was measured using a perineometry device,and the voiding functions were e-valuated with uroflowmetry and 3-day voiding diaries. The urinary system functions were surveyed with the urinary distress inventory-6(UDI-6),the incontinence impact questionnaire-7(IIQ-7)and the overactive bladder questionnaire(OAB-q). Results Pelvic floor muscle strength improvement was significantly higher in the Training group compared to the Control group during postpartum weeks 6 ~ 8(t = 12. 09,P = 0. 003). Qmax and Qmean in the training group differed significantly with control group during postpartum weeks 6 ~ 8(P < 0. 05). The urinary urgency was significantly improved in the Training group compared to the Control group during postpartum weeks 6 ~ 8(t = 5. 06,P = 0. 029;t = 6. 08,P = 0009;t = 16. 88,P < 0. 001,respectively). The UDI-6 and OAB-q scores were significantly improved during postpartum weeks 6~ 8(P < 0. 05). The IIQ-7 in the training group differed significantly with control group during during weeks 28 of pregnancy, during weeks 36 ~ 38 of pregnancy and postpartum weeks 6 ~ 8(P < 0. 05). Conclusion Pregnancy and delivery woulda ffect the strength of pelvic floor muscle,urinary symptoms,quality of life and voiding functions. Functional training of pelvic floor muscle during the pregnancy and postpartum period would increase the strength of pelvic floor muscle and prevent thedeterioration of urinary symptoms,so as to improvethe quality of life.