| 摘要: |
| ［摘要］ 目的 探讨不同干预动作对受试者阴道内压力的影响。方法 选取2024年6月至8月在河南省人民医院妇科盆底中心进行盆底检查的受试者共163例，其中压力性尿失禁（SUI）50例（SUI组），非SUI 113例（非SUI组）。按BMI≥28 kg/m2为肥胖标准，肥胖者8例（肥胖组），非肥胖者155例（非肥胖组）。观察其在仰卧静息状态、腹部肌肉电刺激、卷腹动作、剧烈咳嗽动作、用力排便动作时阴道内压力的变化情况。结果 受试者做剧烈咳嗽动作时阴道内压力最高，为（111.02±15.37）cmH2O，其他依次为用力排便动作［（97.72±11.35）cmH2O］、卷腹动作［（87.15±10.72）cmH2O］、腹部肌肉电刺激［（78.95±7.98）cmH2O］，与仰卧静息状态的阴道内压力［（75.72±7.85）cmH2O］比较差异均有统计学意义（P<0.001）。SUI组在仰卧静息状态、腹部肌肉电刺激、卷腹动作及用力排便动作时的阴道内压力均显著高于非SUI组（P<0.05）；而在剧烈咳嗽动作时两组阴道内压力比较差异无统计学意义（P>0.05）。肥胖组在仰卧静息状态、腹部肌肉电刺激、卷腹动作时的阴道内压力均显著高于非肥胖组（P<0.05）；而在做剧烈咳嗽动作和用力排便动作时两组阴道内压力比较差异无统计学意义（P>0.05）。结论 剧烈咳嗽以及用力排便都会对盆底产生较大的压力，在日常生活中应尽量避免剧烈咳嗽，保持大便通畅。腹部肌肉电刺激相较于卷腹动作对盆底的压力影响更小，是治疗腹直肌分离的更好选择。 |
| 关键词: 阴道内压力 卷腹动作 电刺激 剧烈咳嗽 用力排便 盆底功能障碍性疾病 |
| DOI：10.3969/j.issn.1674-3806.2025.11.07 |
| 分类号:R 711.5 |
| 基金项目:河南省人民医院（郑州大学人民医院）妇产科，郑州 450003 |
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| Clinical observation on effects of different intervention movements on intravaginal pressure in research subjects |
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LUO Suiyu, XU Jun, ZHANG Lingyun, LI Yaping, CHEN Mengyao
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Department of Obstetrics and Gynecology, Henan Provincial People′s Hospital(People′s Hospital of Zhengzhou University), Zhengzhou 450003, China
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| Abstract: |
| ［Abstract］ Objective To explore the effects of different intervention movements on intravaginal pressure in research subjects. Methods A total of 163 subjects who underwent pelvic floor examination in Gynecological Pelvic Floor Center, Henan Provincial People′s Hospital from June 2024 to August 2024 were selected, among whom 50 subjects who suffered from stress urinary incontinence(SUI) were selected as SUI group and 113 subjects without SUI were selected as non-SUI group. Using body mass index(BMI)≥28 kg/m2 as the obesity standard, there were 8 obese individuals(obese group) and 155 non-obese individuals(non-obese group). The changes in intravaginal pressure of the subjects under the conditions of lying on the back at rest, electrical stimulation of abdominal muscles, abdominal crunch movement, forceful coughing and forceful defecation were observed. Results For the subjects, their intravaginal pressure was the highest when they underwent forceful coughing movement［(111.02±15.37)cmH2O］, followed by that when they underwent forceful defecation movement ［(97.72±11.35) cmH2O］, then followed by that when they underwent abdominal crunch movement ［(87.15±10.72)cmH2O］ and finally followed by that when they underwent electrical stimulation of abdominal muscles［(78.95±7.98)cmH2O］. There were statistically significant differences between the intravaginal pressure measured under the conditions of different movements mentioned above and the intravaginal pressure measured under the condition of lying on the back at rest ［(75.72±7.85 )cmH2O］(P<0.001). Under the conditions of lying on the back at rest, electrical stimulation of abdominal muscles, abdominal crunch movement and forceful defecation movement, the intravaginal pressure of the SUI group was significantly higher than that of the non-SUI group(P<0.05). However, there was no statistically significant difference in the intravaginal pressure between the two groups under the condition of forceful coughing movement(P>0.05). Under the conditions of lying on the back at rest, electrical stimulation of abdominal muscles and abdominal crunch movement, the intravaginal pressure of the obese group was significantly higher than that of the non-obese group(P<0.05), and under the conditions of forceful coughing movement and forceful defecation movement, there was no statistically significant difference in the intravaginal pressure between the two groups(P>0.05). Conclusion Both forceful coughing and forceful defecation can exert considerable pressure on the pelvic floor, so in daily life, it is advisable to avoid forceful coughing and keep a normal bowel movement. Compared with abdominal crunch movement, electrical stimulation of abdominal muscles has a smaller impact on pelvic floor pressure. Therefore, electrical stimulation of abdominal muscles is a better choice for treating diastasis recti abdominis. |
| Key words: Intravaginal pressure Abdominal crunch movement Electrical stimulation Forceful coughing Forceful defecation Pelvic floor dysfunction |
