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目的通过比较康复治疗前后的产后妇女压力性尿失禁(SUI)、盆腔脏器脱垂(POP)和盆底肌肉收缩强度的变化,探讨不同分娩方式对盆底功能障碍性疾病(PFD)康复治疗效果的影响。方法选取2012年10月-2014年6月在厦门市妇幼保健院产后门诊就诊的初产妇236例,分为阴道分娩组170例,剖宫产组66例。于产后6周进行盆底功能检测,测定盆底肌力以及POP-Q数值,确定其存在盆底功能障碍,之后遵循自愿原则进行10~15次治疗,治疗结束后再次进行盆底功能检测。由专人询问及填写治疗前后的SUI问卷调查表,并对结果进行统计学分析。结果治疗前,阴道分娩组和剖宫产组SUI和POP发生率比较差异有统计学意义(P<0.05)。阴道分娩组、剖宫产组治疗前和治疗后SUI和POP发生率比较差异有统计学意义(P<0.05)。治疗后,阴道分娩组和剖宫产组SUI和POP发生率比较差异无统计学意义(P>0.05)。治疗前,阴道分娩组和剖宫产组肌纤维肌力下降程度比较差异无统计学意义(P>0.05)。阴道分娩组、剖宫产组治疗前和治疗后肌纤维肌力下降程度比较差异有统计学意义(P<0.05)。治疗后,阴道分娩组和剖宫产组肌纤维肌力下降程度比较差异无统计学意义(P>0.05)。结论阴道分娩及剖宫产均对产后早期盆底肌力有影响,阴道分娩产妇盆底功能更差,各种PFD症状明显,而经过盆底康复治疗后,PFD症状明显减少,患者盆底功能改善,说明盆底康复治疗对产后盆底功能障碍具有防治作用,不同分娩方式的影响无差别,疗效与盆底功能障碍程度、患者依从性有关。
OBJECTIVE: To compare the changes of stress urinary incontinence (SUI), pelvic organ prolapse (POP) and pelvic floor muscle contractility of postpartum women before and after rehabilitation to explore the effects of different modes of delivery on pelvic floor dysfunction (PFD) rehabilitation Effect of effect. Methods Totally 236 primipara from October 2012 to June 2014 in postpartum clinics of Xiamen MCH hospital were divided into vaginal delivery group (170 cases) and cesarean section group (66 cases). Pelvic floor function tests were performed 6 weeks postpartum to determine pelvic floor muscle strength and POP-Q values to determine the presence of pelvic floor dysfunction. Followed by voluntary principles for 10 to 15 times treatment, pelvic floor function test again after treatment. Ask someone by hand and fill in the SUI questionnaire before and after treatment, and the results were statistically analyzed. Results Before treatment, the incidence of SUI and POP in vaginal delivery group and cesarean section was significantly different (P <0.05). The incidence of SUI and POP in vaginal delivery group and cesarean section before and after treatment were significantly different (P <0.05). After treatment, there was no significant difference in the incidence of SUI and POP between vaginal delivery group and cesarean section (P> 0.05). Before treatment, vaginal delivery group and cesarean section muscle fiber decreased the degree of difference was not statistically significant (P> 0.05). Vaginal delivery group, cesarean section group before and after treatment of muscle fiber decreased the degree of difference was statistically significant (P <0.05). After treatment, there was no significant difference in the decrease of myofiber muscle strength in vaginal delivery group and cesarean section group (P> 0.05). Conclusions Both vaginal delivery and cesarean delivery have an effect on the pelvic floor muscle strength during early postpartum. The pelvic floor function of vaginal delivery women is worse, and the symptoms of PFD are obvious. After pelvic floor rehabilitation, the symptoms of PFD are significantly reduced. The pelvic floor function Improvement, pelvic floor rehabilitation treatment of postpartum pelvic floor dysfunction have a preventive effect, the impact of different modes of delivery no difference, efficacy and pelvic floor dysfunction, patient compliance.