妇科人群中腹股沟松弛与盆底肌肉强度和尿失禁的关系

Abdul Mateen, Rukhsar Amanat, Haider Ali, Hurab Khalid, Akram Ali, A. Rehman, Samia Khaliq
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摘要

目的:腹直肌分离(DRA)是指直肌在其纵轴上的异常分离,没有筋膜不规则。目前的研究旨在确定DRA的患病率及其与盆底肌肉力量和尿失禁在费萨拉巴德妇科人群中的潜在关联。这是一项横断面研究。材料与方法:采用简便的抽样技术进行数据采集。从费萨拉巴德政府医院抽取了100名女性样本。研究于2018年2月至2018年5月在费萨拉巴德进行。本研究的纳入标准为:刚产后的妇女、18岁至绝经年龄的妇女和正常阴道分娩的妇女。采用压力测量技术量化盆底肌肉(PFMS)的强度,结果用cmH2O表示。通过询问患者的产后表现来确定尿失禁的发生率。利用腹直肌的指宽评估来测量腹直肌(DRA)移位的程度。这种特殊的测量跨越了脐上下4.5厘米的距离,与白线对齐。结果:通过SPSS version 26对结果进行分析。57%的女性有腹直肌转移。7%的女性盆底肌肉非常弱,38%的女性盆底肌肉弱,50%的女性盆底肌肉强度中等,5%的女性盆底肌肉强度良好。在100例患者中,59%的女性出现尿失禁。腹直肌转移与尿失禁或盆底肌力的相关性均无统计学意义,p值均大于0.05。对理论、实践和政策的启示:纳入产后妇科患者的常规DRAM筛查。教育妇女关于DRAM、其危险因素和预防策略。提倡产后锻炼和理疗,加强腹肌和盆底。提供营养咨询,解决肥胖问题,这是患DRAM的风险因素。实施包括妇科医生、物理治疗师和营养学家在内的多学科方法。对DRAM的长期后果和有效干预措施进行进一步研究。针对医疗保健提供者和公众开展宣传活动,以提高对DRAM的认识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of Diastasis Recti Abdominis with Pelvic Floor Muscle Strenth and Urine Incontinence in Gynecological Population
Purpose: Diastasis recti abdominis (DRA) denotes an anomalous separation of the rectus muscles throughout their longitudinal axis, devoid of fascial irregularities. The current study sought to determine the prevalence of DRA and its potential association with pelvic floor muscular strength and urinary incontinence in the gynaecological population of Faisalabad. This was a cross-sectional study. Materials and Methods: A Convenient sampling technique was used for collecting data. A sample of 100 females from government hospitals of Faisalabad was taken. Study was conducted in Faisalabad from February 2018 to May 2018. Inclusion criteria of the research was, immediate postpartum ladies, females aged 18 to menopausal age, and females who had normal vaginal birth. Manometric techniques were employed to quantify the strength of the pelvic floor muscles (PFMS), with outcomes represented in cmH2O. The incidence of urinary incontinence (UI) was ascertained by querying patients regarding any manifestations postpartum. The extent of diastasis recti abdominis (DRA) was gauged utilizing fingerbreadth assessments of the rectus abdominis muscles. This particular measurement spanned a distance of 4.5 cm both superior and inferior to the umbilicus, aligned with the linea alba. Findings: Results were analyzed through SPSS version 26. Diastasis recti abdominis was found to be present in 57% of the females. 7% of the women had very weak pelvic floor muscle, 38% had weak, 50% had moderate strength and 5% had good strength of pelvic floor muscles. Out of 100, urine incontinence was found in 59% females. There was no statistically significant correlation observed between diastasis recti abdominis muscle and either urinary incontinence or pelvic floor muscle strength, with a p-value exceeding 0.05. Implications to Theory, Practice and Policy: Incorporate routine DRAM screening for postpartum gynecological patients. Educate women about DRAM, its risk factors, and prevention strategies. Promote postpartum exercises and physical therapy to strengthen abdominal muscles and pelvic floor. Provide nutritional counseling to address obesity, a risk factor for DRAM. Implement a multidisciplinary approach involving gynecologists, physiotherapists, and nutritionists. Conduct additional research on the long-term consequences of DRAM and effective interventions. Conduct awareness campaigns targeting both healthcare providers and the public to increase DRAM awareness.
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