微信打卡督导管理模式在产妇产后盆底康复训练中的应用

目的探讨微信打卡督导管理模式对产妇产后盆底康复训练依从性及治疗效果的影响。方法选择2018年3月1日至2018年12月31日在浙江中医药大学附属杭州市西溪医院妇产科住院分娩,并于产后在门诊进行盆底康复训练的100例产妇作为研究对象,将其随机分为观察组和对照组,每组50例产妇。观察组产妇在对照组管理的基础上,采用微信打卡督导的方式将每次盆底肌训练的情况汇报并记录;对照组产妇进行常规微信管理与随访。两组产妇随访6个月后进行康复训练依从性、尿失禁、盆腔脏器脱垂和盆腔脏器脱垂/尿失禁性生活质量问卷调查,同时在治疗前后采用盆底治疗仪对I、Ⅱ类肌纤维肌力进行检测。通过分析上述相关指标,评价2种管理方式对产妇产后盆底康复训练依从性及治疗效果的差异。结果观察组产妇盆底康复训练依从性良好率(80.0%)显著优于对照组产妇(56.0%),依从性差占比(8%)低于对照组产妇(54%),其差异均具有统计学意义(均P<0.05)。观察组产妇训练后I、Ⅱ类肌纤维肌力(4.34±0.22,3.82±0.34)均高于对照组产妇(2.62±0.42,2.32±0.42),尿失禁(6%)和盆腔脏器脱垂(8%)发生率均明显低于对照组产妇(22%,24%),产后PISQ-12评分[(35.35±4.43)分]高于对照组产妇[(32.24±3.62)分],其差异均具有统计学意义(均P<0.05)。结论微信打卡督导管理模式可以提高产妇产后盆底康复训练的依从性,增强康复训练的效果。

Application of WeChat clock in mode in postpartum pelvic functional rehabilitation training

Objective To observe the impact of WeChat clock in mode on the compliance and treatment effect of patients receiving postpartum pelvic functional rehabilitation training. Methods 100 patients treated with biofeedback electrical stimulation combined with pelvic floor muscle exercises in our hospital from March 1 to December 21, 2018 were randomized into a control group(n=50),who received routine management and follow-up through WeChat and an observation group(n=50), who were additionally required to clock in through WeChat and report the conditions of pelvic floor muscle training on the basis of the control group, and also tracked and recorded by the nurses. Questionnaire surveys on the rehabilitation training compliance, urinary incontinence, pelvic organ prolapse and pelvic organ prolapse-urinary incontinence sexual function questionaire were investigated after 6 months′ follow-up in the two groups. At the same time, pelvic floor therapeutic apparatus was used to detect the muscle strength of class I and II muscle fibers before and after treatment. The compliance of the two kind of managements and treatment effects were evaluated through the analysis of the above-mentioned indicators. Results The good compliance rate of pelvic floor rehabilitation training in the observation group(80.0%) was significantly better than that in control group(56.0%), and the proportion of poor compliance(8%) was lower than that in control group(54%), all with statistically significant differences(all P<0.05). After training, the I, Ⅱ muscle strength of the observation group(4.34±0.22, 3.82±0.34) was higher than those of the control group(2.62±0.42, 2.32±0.42), the incidence of urinary incontinence(6%) and pelvic organ prolapse(8%) were significantly lower than those of the control group(22%, 24%), and the postpartum PISQ-12 score(35.35±4.43) was significantly higher than that of the control group(32.24±3.62), all with statistically significant differences(all P<0.05). Conclusions WeChat clock in mode can improve patient compliance with postpartum pelvic functional rehabilitation training and increase the effect of training.