观察围生期妇女盆底肌肌力变化趋势及持续性指导孕(产)妇进行盆底肌锻炼(PFMT)对产后盆底肌肌力的影响。

选择2010年12月至2011年3月在广州市某三甲医院产科门诊进行规律产检的106例孕妇为研究对象，将其按照随机数字表法分为持续指导组(n＝51)和对照组(n＝55)，并按照孕妇首诊时孕龄分为1组(16～19孕周，n＝21)，2组(20～23孕周，n＝26)，3组(24～27孕周，n＝30)和4组(28～31孕周，n＝29)。采用手测肌力法测量两组孕(产)妇首诊时、产后6周及3个月盆底肌肌力(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，并征得受试对象本人的知情同意，与之签署临床研究知情同意书)。两组孕妇年龄等一般情况比较，差异无统计学意义(P<0.05)。

持续指导组孕(产)妇产后6周、产后3个月盆底各类纤维肌力均优于对照组，两组比较，差异有统计学意义(P<0.05)。持续指导组除深Ⅱ类纤维外，孕期首诊时各类纤维肌力优于产后6周(P<0.05)，产后3个月各类纤维肌力优于产后6周(P<0.05)，而孕期首诊与产后3个月各类纤维肌力比较，差异无统计学意义(P>0.05)。对照组孕期首诊时各类纤维肌力均高于产后6周和产后3个月，前者与后两者比较，差异均有统计学意义(P<0.05)，而产后6周与产后3个月肌力比较，差异无统计学意义(P>0.05)。

孕期盆底肌肌力随孕龄增加而呈逐渐下降趋势，以孕晚期下降最为显著。产后盆底功能有一定康复趋势，良好的PFMT更有助于产后盆底肌肌力恢复。

To observe the trends of the pelvic muscle myodynamia during the perinatal stage and to evaluate the effect of nursing intervention of pelvic floor muscle training (PFMT) on the postpartum pelvic muscle myodynamia.

From December 2010 to March 2011, 106 nullipara who conducted regular check-ups in Guangzhou were included in the study, and divided into intervention group(n=51) and control group(n=55) randomly.They wrer also divided into group 1 (16 to 19 weeks of gestation, n=21), group 2 (20 to 23 weeks of gestation, n=26), group 3 (24 to 27 weeks of gestation, n=30) and group 4 (28 to 31 weeks of gestation, n=29) according to their gestational age.The pelvic muscle myodynamia were measured before intervention during gestational period and 6 weeks and 3 months after delivery. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangzhou Medical University.Informed consent was obtained from each patients. There were no significant difference in general clinical data between two groups (P>0.05).

The pelvic muscle myodynamia of women in intervention group were better than that of control group at 6 weeks and 3 months after delivery(P<0.05). Except fiber type Ⅱ, There were significant differences in pelvic muscle myodynamia of other fiber types in intervention group between before intervention during gestational period and 6 weeks after delivery(P<0.05). The pelvic muscle myodynamia of all fiber types at 3 months after delivery were better than those of 6 weeks after delivery(P<0.05). There was no significant difference between 3 months after delivery and before intervention during pregnancy(P>0.05). There had significant differences in pelvic muscle myodynamia between before intervention during pregnancy women and 6 weeks and 3 months after delivery in control group respectively(P<0.05), and there was no significant difference between 6 weeks and 3 months after delivery(P>0.05).

The pelvic muscle myodynamia of the pregnant women is declined with the increase of the gestational age, and the most significant period is the third trimester of pregnancy. Although there is a certain trend in rehabilitation of postpartum pelvic floor fuction, the PFMT still can promote the recovery of postpartum pelvic floor muscle myodynamia.