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手法淋巴引流与会阴按摩对妊娠水肿的经产妇有效性比较:一项随机临床试验。

Effectiveness of manual lymphatic drainage vs. perineal massage in secundigravida women with gestational oedema: A randomised clinical trial.

机构信息

Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, 28670, Spain.

Facultad de Enfermería, Físioterapia y Podologia, Universidad Complutense de Madrid, Madrid, 28040, Spain.

出版信息

Int Wound J. 2020 Oct;17(5):1453-1461. doi: 10.1111/iwj.13427. Epub 2020 Jun 13.

Abstract

Perineal trauma (PT) may be considered as a very common injury during the childbirth. The incidence of PT was estimated in 30% to 85%, with 60% to 70% requiring suture. The present study was a prospective, single-blinded, randomised, clinical trial carried out from January 2015 to January 2016. For this study, 49 secundigravida women diagnosed with gestational oedema were recruited and randomly divided into two groups (A and B). Group A (n = 30) received the conventional treatment plus perineal massage and group B (n = 19) the conventional treatment plus manual lymphatic drainage (MLD). Visual analogue scale (VAS) and King Health's Questionnaire (KHQ) were performed to assess pain intensity and quality of life-related with urinary incontinence (UI). Pain intensity measurements showed statistically significant differences for a decrease after 30-weeks (P = .037), after 36-weeks (P = .000), and at the end of puerperium (P = .014) for MLD with respect to perineal massage group. Moreover, inter-groups repeated measures ANOVA for the values related statistically significant differences to the interaction of each applied treatment (perineal massage and MLD group, separately) over the pain intensity variable. MLD treatment reduced pain intensity with respect to perineal massage in secundigravida women with gestational oedema from 25-weeks of gestation to the end of puerperium.

摘要

会阴创伤(PT)可能被认为是分娩过程中非常常见的损伤。PT 的发生率估计为 30%至 85%,其中 60%至 70%需要缝合。本研究为前瞻性、单盲、随机、临床试验,于 2015 年 1 月至 2016 年 1 月进行。在这项研究中,招募了 49 名被诊断为妊娠水肿的经产妇,并随机分为两组(A 和 B)。A 组(n=30)接受常规治疗加会阴按摩,B 组(n=19)接受常规治疗加手动淋巴引流(MLD)。采用视觉模拟评分(VAS)和 King Health's Questionnaire(KHQ)评估疼痛强度和与尿失禁(UI)相关的生活质量。疼痛强度测量显示,在 30 周后(P=0.037)、36 周后(P=0.000)和产褥期末(P=0.014),MLD 组与会阴按摩组相比,疼痛强度有统计学意义的降低。此外,对每组间的重复测量方差分析显示,与两种应用治疗(分别为会阴按摩和 MLD 组)对疼痛强度变量的交互作用相关的数值存在统计学显著差异。在妊娠水肿的经产妇中,与会阴按摩相比,MLD 治疗从 25 周妊娠开始至产褥期末减轻了疼痛强度。

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