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目的探讨孕期及产褥期有氧运动的干预对女性压力性尿失禁及盆底组织的影响。方法选取2010年3月至2012年4月期间在我院产科门诊进行产前检查的初孕妇200名,随机分为2组:锻炼组从孕20周起至产后42d在专人指导下进行相关产力储备及盆底肌肉锻炼的有氧运动;对照组孕期及产后不进行此类运动,仅接受一般产前检查及产后健康知识宣教。分别在孕20周、孕38周、产后42d时采用PHENIX盆底肌肉康复系统检测2组孕产妇的盆底肌张力,测量体质量,计算体质量指数。同时采用国际尿控协会推荐的国际尿失禁标准问卷进行调查,了解两组三时段尿失禁情况,比较分析两组的检测结果。结果孕20周时(运动前),两组体质量指数、尿失禁发生率、盆底肌肉张力检测组间无统计学差异(P>0.05)。38周时,两组体质量指数(27.80±2.47vs29.70±3.17)、尿失禁发生率(14.29%vs27.96%)、盆底肌张力(<Ⅲ级80.61%vs94.62%或≥Ⅲ级19.39%vs6.45%)3项观察指标比较差异有统计学意义(22.92±2.72vs24.35±2.68,5.10%vs12.90%,<Ⅲ级32.65%vs68.82%或≥Ⅲ级48.98%vs31.18%,P均﹤0.05),产后锻炼组与对照组间此三项观察指标比较差异有统计学意义(P均<0.05)。结论孕期及产褥期规律适宜的有氧运动,可降低孕产妇体质量指数,有效预防压力性尿失禁的发生。同时减轻盆底组织损伤,促进盆底肌功能恢复。
Objective To investigate the effects of pregnancy and puerperium aerobic exercise on female stress urinary incontinence and pelvic floor tissue. Methods From March 2010 to April 2012 in our hospital gynecological clinic for prenatal care of 200 pregnant women were randomly divided into two groups: exercise group from 20 weeks pregnant to 42d postpartum under the guidance of a hand related Power reserve and pelvic floor muscle exercise aerobic exercise; control group during pregnancy and postpartum without such exercise, only accept the general prenatal care and postnatal health education. The pelvic floor muscle tension of two groups of pregnant women were measured by PHENIX pelvic floor muscle rehabilitation system at 20 weeks of gestation, 38 weeks of gestation and 42 days of postpartum. The body mass was measured and the body mass index was calculated. At the same time, the international urinary incontinence standard questionnaire recommended by the International Association of Urinary Control was used to investigate the situation of urinary incontinence in two groups for three periods and to compare the test results of the two groups. Results At 20 weeks of pregnancy (before exercise), there was no significant difference between the two groups in the body mass index, the incidence of urinary incontinence and pelvic floor muscle tension (P> 0.05). At week 38, body mass index (27.80 ± 2.47 vs. 29.70 ± 3.17), urinary incontinence (14.29% vs 27.96%), pelvic floor muscle tension (<80.61% vs94.62% or≥3 Grade 19.39% vs6.45%). There were significant differences between the three observation items (22.92 ± 2.72vs24.35 ± 2.68,5.10% vs12.90%, <32.65% vs68.82% or≥48.98% vs31.18% respectively, all P <0.05). There were significant differences among the three observation indexes in postpartum exercise group and control group (all P <0.05). Conclusions The proper aerobic exercise during pregnancy and puerperium can reduce the body mass index of pregnant women and effectively prevent the occurrence of stress urinary incontinence. At the same time reduce the pelvic floor tissue damage, promote pelvic floor muscle function recovery.