孕期盆底肌肉訓練對產后盆底功能及第二產程的影響

厲蒙 鄭美鳳 王曉蕾 胡迎春

[摘要] 目的 探討孕期盆底肌肉訓練對產后盆底功能及第二產程的影響。 方法 選擇2017年1～8月在我院進行孕期保健并分娩的孕產婦200例為研究對象，隨機分為干預組與對照組，各100例。對照組進行常規孕期保健及健康教育，干預組自孕14周開始進行盆底肌肉訓練，至產后42 d。統計兩組順產、剖宮產、新生兒窒息、產后出血發生率。比較第二產程時間、產后3個月陰道收縮壓、陰道靜息壓、陰道收縮持續時間，壓力性尿失禁及盆腔臟器脫垂發生率。 結果 干預組剖宮產率顯著低于對照組，新生兒窒息率、產后出血率顯著低于對照組，第二產程時間顯著短于對照組，差異有統計學意義（P<0.05）。產后3個月，干預組VSP、VRP顯著高于對照組，陰道收縮持續時間長于對照組，差異有統計學意義（P<0.05）。產后3個月，干預組壓力性尿失禁、盆腔臟器脫垂發生率顯著低于對照組，差異有統計學意義（P<0.05）。 結論 孕期進行盆底肌肉訓練能夠顯著縮短第二產程，改善產后盆底功能。

[關鍵詞] 盆底肌肉訓練;第二產程;產后;盆底功能

[中圖分類號] R714.3? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2019）09-0056-04

[Abstract] Objective To investigate the effects of pelvic floor muscle training during pregnancy on postpartum pelvic floor function and second stage of labor. Methods A total of 200 pregnant women who underwent pregnancy care and delivered in our hospital from January to August 2017 were randomly divided into intervention group and control group， with 100 cases in each group. The control group underwent routine pregnancy health and health education. The intervention group performed pelvic floor muscle training from the 14th week of pregnancy to 42 days after delivery. The incidence of natural labour， cesarean section， neonatal asphyxia， and postpartum hemorrhage were counted. The second stage of labor， vaginal systolic pressure at 3 months after delivery， vaginal resting pressure， vaginal contraction duration， the incidence of stress urinary incontinence and pelvic organ prolapse were compared. Results The cesarean section rate of the intervention group was significantly lower than that of the control group. The neonatal asphyxia rate and postpartum hemorrhage rate of the intervention group were significantly lower than those of the control group. The second stage of labor in the intervention group was significantly shorter than that of the control group. And the difference was statistically significant（P<0.05）. At 3 months after delivery， the VSP and VRP in the intervention group were significantly higher than those in the control group. The duration of vaginal contraction in the intervention group was longer than that in the control group， and the difference was statistically significant（P<0.05）. At 3 months after delivery， the incidence of stress urinary incontinence and pelvic organ prolapse in the intervention group was significantly lower than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion Pelvic floor muscle training during pregnancy can significantly shorten the second stage of labor and improve postpartum pelvic floor function.