妊娠晚期盆底肌锻炼对产后膀胱功能障碍及尿动力学的影响

曾纪仪　林忠　银河　王慧　黄青玉

【摘要】 目的：探析妊娠晚期盆底肌锻炼对产后膀胱功能障碍及尿動力学的影响。方法：选取2017年8月-2018年4月在本院进行产前检查的妊娠晚期孕妇100例为研究对象，生产过程中由于各种因素最终有70例孕妇选择了经阴道分娩。按照随机数字表法将其分为试验组和参照组，各35例。参照组给予常规产前检查，试验组在参照组基础上给予盆底肌功能锻炼。比较两组产后尿潴留及尿失禁发生率、盆底肌张力、尿动力情况。结果：试验组产后尿潴留、尿失禁发生率均低于参照组（P<0.05）;试验组产后盆底肌张力正常率为82.86%，高于参照组的57.14%（P<0.05）;试验组最大膀胱容量、最大尿流率均大于参照组（P<0.05）。结论：将盆底肌锻炼应用于妊娠晚期孕妇中能够预防产后膀胱功能障碍，保障产后尿动力正常，值得推广。

【关键词】 盆底肌锻炼; 妊娠晚期; 膀胱功能障碍; 尿动力学

【Abstract】 Objective：To explore the effect of pelvic floor muscle exercise on postpartum bladder dysfunction and urodynamics in late pregnancy.Method：A total of 100 late pregnant women who underwent prenatal examination in our hospital from August 2017 to April 2018 were selected as the research objects，in the course of production，70 pregnant women chose vaginal delivery because of various factors.According to the random number table method，they were divided into experimental group and reference group，35 cases in each group.The reference group was given routine prenatal examination，and experimental group was given pelvic floor muscle functional exercise on the basis of reference group.The incidence of postpartum urinary retention and incontinence，pelvic floor muscle tension and urinary motility between two groups were compared.Result：The incidence of postpartum urinary retention and incontinence in experimental group were lower than those of reference group（P<0.05）.The normal rate of pelvic floor muscle tension was 82.86% in experimental group，which was higher than 57.14% of reference group（P<0.05）.The maximal bladder volume and urinary flow rate in experimental group were higher than those of reference group（P<0.05）.

Conclusion：Pelvic floor muscle exercise in late pregnancy pregnant women can prevent postpartum bladder dysfunction，ensure normal postpartum urodynamic，worthy of promotion.

【Key words】 Pelvic floor muscle exercise; Late pregnancy; Bladder dysfunction; Urodynamics

First-authors address：Liuzhou Maternity and Child Health Care Hospital，Liuzhou 545001，China

doi：10.3969/j.issn.1674-4985.2019.08.032

妊娠或分娩过程会对孕产妇的盆底肌产生某种程度的损伤，包括直接机械损伤和阴部神经受损造成的间接损伤，这些损伤可进一步导致产后尿潴留、尿失禁等并发症，尿潴留和尿失禁就是产后膀胱功能障碍的常见类型[1-2]。盆底肌功能锻炼是预防及治疗产后膀胱功能障碍的临床常用措施[3-5]。本研究探究妊娠晚期盆底肌锻炼对产后膀胱功能障碍及尿动力学的影响。现报道如下。

1 资料与方法

1.1 一般资料 选取2017年8月-2018年4月在本院进行产前检查的妊娠晚期孕妇100例为研究对象。纳入标准：孕周28～32周;单胎;初产妇;准备采用阴道分娩且符合阴道分娩适应证。排除标准：有先兆流产、先兆早产者;合并妊娠期糖尿病及高血压疾病者。生产过程中由于各种因素最终有70例孕妇选择了经阴道分娩。按照随机数字表法将其分为试验组和参照组，各35例。……