初产妇产后盆底功能锻炼对盆腔器官脱垂影响的临床研究

目的：评估盆底功能锻炼对初产妇产后盆腔器官脱垂（ POP）分期和症状的预防及治疗作用。方法将189例初产妇随机分为实验组和对照组，实验组在产后6～8周进行盆底功能锻炼，维持4个月，对照组未进行干预。结果实验组和对照组基线值（产后6周）的POP分期（χ2＝2．372， P＝0．640），POP-Q位点（P＞0．05）和膀胱颈位置（P＞0．05）差异无统计学意义；实验组和对照组确诊POP-QⅡ度的初产妇在产后6周和6个月的相对风险度无显著性变化（χ2＝2．204，P＝0．533；χ2＝2．407，P＝0．326）；对照组在产后6个月阴道内膨胀症状的初产妇数量明显高于实验组（χ2＝25．69，P＝0．001）。结论产后盆底功能锻炼对初产妇产后盆腔器官脱垂没有影响；对于特定人群需要更多的随机对照性研究确定盆底功能锻炼对盆腔器官脱垂症状的影响。

Effect of postpartum pelvic floor muscle training on pelvic organ prolapse in primiparous women

Objective To evaluate the effect of pelvic floor muscle training ( PFMT) on prevention and treatment of stage and symptoms of pelvic organ prolapse ( POP) in primiparous postpartum women .Methods A total of 189 primiparous postpartum women were randomly divided into experimental group and control group .Patients in the experimental group participated in a 4-month PFMT starting at 6-8 week after delivery, and those in the control group were not treated .Results No significant differences were found in the POP stage (χ2 =2.372, P=0.640), pelvic organ prolapse quantitation (POP-Q) site (P>0.05) and bladder neck position (P>0.05) at baseline (6 week after delivery) between the experimental group and the control group .No significant change was found between two groups in relative risk of being diagnosed with POP-Q stage II at 6 week and 6 month after delivery (χ2 =2.204, P=0.533;χ2 =2.407,P=0.326).Number of women with symptoms of bulging inside vagina was significantly higher in the control group compared to the PFMT group at 6 month after delivery (χ2 =25.69, P =0.001).Conclusion Postpartum PFMT has no effect on POP in primiparous women.More randomized controlled trials are needed before strong conclusions can be drawn on the effect of PFMT on POP in particular population .