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盆底肌强化训练对产后发生产科肛门括约肌损伤的女性功能状态的影响

The Impact of Pelvic Floor Muscle Strengthening on the Functional State of Women Who Have Experienced OASIS After Childbirth.

作者信息

Simanauskaitė Atėnė, Kačerauskienė Justina, Railaitė Dalia Regina, Bartusevičienė Eglė

机构信息

Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2024 Dec 27;61(1):22. doi: 10.3390/medicina61010022.

Abstract

The primary objective of this study was to assess the impact of pelvic floor muscle (PFM) strengthening on the pelvic floor function in women who have experienced OASIS two years after delivery, and the secondary objective was to educate women about PFM strengthening and instruct them on the correct way to exercise. A prospective case-control study was conducted. The participants were divided into two groups: the case group (women who experienced OASIS) and the control group (women who did not experience perineal tears but had similar obstetric-related data to the case). Women were invited for a gynecological exam, PFM assessment, and consultation on PFM training. Women in the case group had three consultations, and women in the control group had two. Women were presented with four sets of questions about pre-pregnancy condition and questions related to UI and FI after delivery. Results were considered significant when < 0.05. OASIS were detected in 13 (0.4%) women in 2021. Risk factors for OASIS were found to be fetal macrosomia ( = 0.012), fetal occiput posterior position ( = 0.001), and epidural analgesia ( = 0.003). After one year of performing PFM strengthening exercises, some women in the study group exhibited stronger PFM contractions ( = 0.076), while others held the contracted PFM for a longer time ( = 0.133). UI affected women in the control group more often ( = 0.019). Two years after delivery, gas incontinence was mentioned significantly more frequently in the case group ( = 0.019). One year after initial consultation, gas incontinence was also more significantly common in the case group ( = 0.037). This study found that PFM strengthening exercises significantly improved pelvic floor function in women who experienced OASIS two years after delivery. Participants exhibited stronger PFM contractions and an increased ability to maintain these contractions. Women reported a better understanding of PFM exercises and proper techniques.

摘要

本研究的主要目的是评估盆底肌肉(PFM)强化训练对产后两年发生产科肛门括约肌损伤(OASIS)的女性盆底功能的影响,次要目的是对女性进行盆底肌肉强化训练的教育,并指导她们正确的锻炼方法。进行了一项前瞻性病例对照研究。参与者被分为两组:病例组(发生OASIS的女性)和对照组(未发生会阴撕裂但产科相关数据与病例组相似的女性)。邀请女性进行妇科检查、盆底肌肉评估以及盆底肌肉训练咨询。病例组女性进行了三次咨询,对照组女性进行了两次。向女性提出了四组关于孕前状况以及产后尿失禁(UI)和粪失禁(FI)相关问题。当P<0.05时,结果被认为具有显著性。2021年,在13名(0.4%)女性中检测到OASIS。发现OASIS的危险因素为巨大儿(P = 0.012)、胎儿枕后位(P = 0.001)和硬膜外镇痛(P = 0.003)。在进行一年的盆底肌肉强化训练后,研究组中的一些女性表现出更强的盆底肌肉收缩(P = 0.076),而另一些女性保持盆底肌肉收缩的时间更长(P = 0.133)。对照组中尿失禁影响女性的情况更常见(P = 0.019)。产后两年,病例组中气体失禁被提及的频率显著更高(P = 0.019)。在初次咨询一年后,病例组中气体失禁也更显著常见(P = 0.037)。本研究发现,盆底肌肉强化训练显著改善了产后两年发生OASIS的女性的盆底功能。参与者表现出更强的盆底肌肉收缩以及维持这些收缩的能力增强。女性报告对盆底肌肉锻炼和正确技巧有了更好的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1343/11766744/d3207b4d1d04/medicina-61-00022-g001.jpg

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