厉蒙 郑美凤 王晓蕾 胡迎春

[摘要] 目的 探討孕期盆底肌肉训练对产后盆底功能及第二产程的影响。 方法 选择2017年1～8月在我院进行孕期保健并分娩的孕产妇200例为研究对象，随机分为干预组与对照组，各100例。对照组进行常规孕期保健及健康教育，干预组自孕14周开始进行盆底肌肉训练，至产后42 d。统计两组顺产、剖宫产、新生儿窒息、产后出血发生率。比较第二产程时间、产后3个月阴道收缩压、阴道静息压、阴道收缩持续时间，压力性尿失禁及盆腔脏器脱垂发生率。 结果 干预组剖宫产率显著低于对照组，新生儿窒息率、产后出血率显著低于对照组，第二产程时间显著短于对照组，差异有统计学意义（P<0.05）。产后3个月，干预组VSP、VRP显著高于对照组，阴道收缩持续时间长于对照组，差异有统计学意义（P<0.05）。产后3个月，干预组压力性尿失禁、盆腔脏器脱垂发生率显著低于对照组，差异有统计学意义（P<0.05）。 结论 孕期进行盆底肌肉训练能够显著缩短第二产程，改善产后盆底功能。

[关键词] 盆底肌肉训练;第二产程;产后;盆底功能

[中图分类号] R714.3          [文献标识码] B          [文章编号] 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.