李小梅 伍丽燕 梁燕梅 苏丽嬛

【摘要】 目的：研究科學规范的孕期运动课程对第二产程时长及产后盆底康复的影响。方法：选取2016年2-8月在肇庆市高要区人民医院建档立册的单胎妊娠初孕妇200名作为研究对象，按照随机数字表法将其分成运动干预组和对照组，进行定期随访，按要求随访至产后3个月，随访结束后，符合以上标准的共146名，其中运动干预组65名和对照组81名。两组给予常规产检，并进行生活及营养指导，对照组不进行运动干预，运动干预组每2周来院进行孕期健康知识教育。比较观察两组孕妇分娩时第二产程所用时间及产后3个月时阴道收缩持续时间、阴道静息压（VRP）及阴道收缩压（VSP）。结果：运动干预组的阴道分娩第二产程所用时间明显短于对照组，产后3个月时阴道收缩时间明显长于对照组，且VRP和VSP均明显高于对照组，差异均有统计学意义（P<0.05）。结论：坚持规范科学的孕期运动能缩短初产妇第二产程时长，亦可减轻盆底组织损伤，促进产后盆底肌肉的康复。从事围生期保健人员应重视孕期运动，并应加强对孕期运动的方式、强度及安全性和有效性研究，从而为孕妇提供更合理化、个体化、多样化的孕期运动建议。

【关键词】 孕期运动； 第二产程； 盆底功能

【Abstract】 Objective：To investigate the effects of scientific and standardized exercise courses during pregnancy on the length of the second stage of labor and postpartum pelvic floor rehabilitation.Method： A total of 200 first-trimester pregnant women with single pregnancy from February to August 2016 in the Gaoyao District Peoples Hospital of Zhaoqing City as the study objects.According to the random number table method，they were divided into the exercise intervention group and the control group.The pregnant women were followed up regularly until postpartum 3 months.After the follow-up，a total of 146 cases met the above criteria，including 65 cases in the exercise intervention group and 81 cases in the control group.The two groups were given routine examinations and provided life and nutrition guidance.The control group wasnt given exercise intervention，the exercise intervention group was given health education during pregnancy every 2 weeks.The duration of the second stage of labor and the duration of vaginal contraction postpartum 3 months，vaginal resting pressure （VRP） and vaginal systolic blood pressure （VSP） were compared and observed between the two groups.Result：The duration of the second stage of vaginal delivery in the exercise intervention group was significantly shorter than that in the control group，the duration of vaginal contraction postpartum 3 months was significantly longer than that in the control group，and the VRP and VSP were significantly higher than those in the control group，the differences were statistically significant （P<0.05）.Conclusion： Adhering to the normative and scientific exercise during pregnancy can shorten the length of the second labor stage of the first-trimester pregnant women，reduce the pelvic floor tissue damage，and promote the recovery of pelvic floor muscles after delivery.Perinatal health care personnel should pay attention to the exercise during pregnancy，and should strengthen the study of the mode，intensity and safety and effectiveness of the exercise during pregnancy，so as to provide pregnant women with more rationalized，individual and diversified recommendations during pregnancy.

【Key words】 Pregnancy exercise； Second stage of labor； Pelvic floor function

First-authors address：Zhaoqing Medical College，Zhaoqing 526020，China

doi：10.3969/j.issn.1674-4985.2018.24.039

孕期运动对孕产妇的精神状态、孕期体重控制、胎儿生长发育、产后康复甚至孕产妇与胎儿的长远健康有着极其重要的影响。国外很早已经开始研究孕期运动对妊娠及分娩的影响，但我国在研究孕期体力活动方面相对滞后，大大降低了常规孕期保健和分娩期保健的服务质量。大部分产科专科医生与妇幼保健科医师认为孕期积极的体力活动對促进自然分娩是有好处的[1]。中国的传统理念认为，孕期应该减少活动、注意休息，得以顺利度过孕期，所以我国普遍存在孕期运动量不足、体能下降、孕期体重超标，造成胎儿过大，引起难产，令盆底肌受损，这些问题影响了孕妇对分娩的体验，在产程中需要更多的干预，增加了医护人员的负担，造成医疗成本的上涨[2]。……