Study on changes of pelvic floor muscle strength and stress urinary incontinence during pregnancy
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF PERINATAL MEDICINE
- Issue:
- 3
- DOI:
- 10.3760/cma.j.issn.1007-9408.2007.03.001
- Key Word:
- 妊娠并发症;骨盆底;肌张力;尿失禁,压力性
Abstract： 目的 通过调查孕期妇女压力性尿失禁(stress urinary incontinence,SUI)的发病情况,测定各孕期妇女盆底肌张力,分析孕期尿失禁发病的相关因素及盆底肌训练的作用,以便寻求更好的预防孕期与产后尿失禁的时机和方法.方法 选取2005年1月至4月间常规孕期检查而未进行过盆底肌训练的健康初产妇为研究对象,分为三组: 第1组孕11～周;第2组孕18～周;第3组孕28～37周.调查SUI的发病情况、测量盆底肌张力值,并选取部分孕妇行盆底肌锻炼,定期随访.对各组孕妇的盆底肌张力值和尿失禁的发病情况进行统计分析.结果 纳入研究的孕妇共374例,三组不同程度SUI的发病率依次为12.8%、24.0%、32.0%,盆底肌张力的活力均值和做功均值随孕周增加而逐渐降低. 第1组盆底肌张力的做功值与孕前BMI呈负相关(r＝-0.185,P＝0.046),孕前进行一般体育锻炼者的盆底肌张力活力值大于不锻炼者(15.35±10.01和12.19±5.59,P=0.033).第3组有SUI者的产时BMI大于无尿失禁者(20.91±2.97和20.04±1.59,P=0.012).部分孕妇进行盆底肌锻炼,孕37周随访,锻炼组的尿失禁发病率低于不锻炼组(22.2%和5.6%,P＜0.01);锻炼组的盆底肌张力活力值和做功值大于不锻炼组(P＜0.001,P＜0.05).结论 孕期妇女SUI发病率随孕周增加而逐渐增加,而盆底肌张力值逐渐下降.孕前体育锻炼可以增加盆底组织的弹性和收缩能力.孕前BMI越大盆底肌的支持力和耐力越弱.尿失禁者的产时BMI大于无尿失禁者.盆底肌锻炼者可能对尿失禁发病率有预防作用.
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