盆底肌肉锻炼的不同训练时机对盆底肌力的影响

目的 探讨产后第1周与第7周开始Kegel训练进行盆底肌肉锻炼在提高盆底肌力中的应用效果.方法 选取2015年9月至2016年6月在汉川市人民医院妇产科就诊的268例足月阴道分娩的单胎初产妇,随机分为研究组和对照组,两组各134例.研究组于产后第1周开始Kegel训练进行盆底肌肉锻炼,对照组则于产后第7周开始进行锻炼,均锻炼1个月.对比两组产后3个月、6个月盆底肌力、盆腔器官脱垂定量分类及压力性尿失禁的发生情况.结果 研究组产后3个月、6个月盆底Ⅰ类肌纤维肌电压、盆底Ⅱ类肌纤维肌电压均高于对照组(t=3.53~4.65,均P<0.05);研究组产后3个月、6个月盆腔器官脱垂定量分类法0度比例高于对照组(χ2值分别为4.13、4.19,均P<0.05),而Ⅰ度比例、Ⅱ度比例低于对照组(Ⅰ度:χ2值分别为3.89、3.97,均P<0.05;Ⅱ度:χ2值分别为3.75、3.69,均P<0.05);研究组产后3个月、6个月压力性尿失禁发生率均低于对照组(χ2值分别为6.96、6.25,均P<0.05).结论 产后第1周开始Kegel训练进行早期盆底肌肉锻炼有助于改善盆底肌力,从而能够明显减轻压力性尿失禁发生率.

Effects of pelvic floor muscle training at different time on pelvic floor muscle strength

Objective To investigate the application of pelvic floor muscle training to improve pelvic floor muscle strength by Kegel training starting from the first week and seventh week after birth .Methods Totally 268 cases of full-term vaginal delivery of primiparas were selected in People Hospital in Hanchuan City and were randomly divided into study group and control group with 134 cases in each .Cases in the study group accepted Kegel training for pelvic floor muscle training from the first week after birth , while cases in the control group began to exercise from the seventh week after birth .Both training lasted one month .The pelvic floor muscle strength , pelvic organ prolapse quantification (POP-Q) and incidence of stress urinary incontinence (SUI) were compared between two groups at 3 and 6 months after birth.Results The average of type I muscle fiber voltage and type Ⅱ muscle fiber voltage of the study group at 3 and 6 months after birth were higher than those in the control group (t value ranged 3.53-4.65, both P<0.05).The proportion of cases with POP-Q of zero degree in the study group after 3 and 6 months after birth was higher than that in the control group (χ2 value was 4.13 and 4.19, respectively, both P<0.05), but the proprtions of POP-Q ofⅠdegree and Ⅱdegree were lower (Ⅰdegree:χ2 value was 3.89 and 3.97;Ⅱdegree:χ2 value was 3.75 and 3.69, respectively, all P<0.05).The incidence rate of SUI in the study group after 3 and 6 months after birth was lower than that in the control group (χ2 value was 6.96 and 6.25, respectively, both P<0.05).Conclusion Kegel training for pelvic floor muscle training starting from the first week after birth is helpful to improve the pelvic floor muscle strength , which can significantly reduce the incidence rate of SUI .