以下肢静脉曲张疾病为首发表现的孕妇的物理治疗

Yu.L. Tonkopei, T. Buhaienko, O. Bespalova, Yu.M. Maliarova, O. Prysiazhniuk
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引用次数: 0

摘要

由于临床经验的归纳,已经证明孕妇下肢静脉曲张疾病是一种静脉系统的多学疾病。孕妇静脉曲张的高病理性发病率是由许多因素引起的。这种变化的后果可能是下肢静脉床的停滞。因此,有下肢静脉曲张原发病史的妇女,往往在妊娠期和产后出现问题,表现为血栓性静脉炎(浅静脉炎症)的并发症。及时开始并实施物理治疗,可以缓解或完全消除孕妇的上述疾病症状,显著改善血液循环特性和血管内壁状况。本研究的目的是评估以下肢静脉曲张为主要表现的妊娠中期和晚期妇女的身体功能状态以及物理治疗方案的有效性。方法和材料。19名患有静脉曲张的孕妇参加了这项研究,年龄在22岁到29岁之间,从怀孕的第二到第三个月。分为两组:主组10名妇女(实施已开发的物理治疗方案,包括运动疗法,治疗和电泳)和对照组9名妇女(实施标准物理治疗技术)。研究采用以下方法:1)人体测量法;2)对女性心血管系统功能指标进行生理监测(测脉、测压,系统记录收缩压、舒张压、心率等指标;3)功能诊断(主动直立试验、肺活量测定);4)参与临床体镜检查;5)生活质量评估。结论。在妊娠的不同时期,检查的患者被诊断为原发性下肢静脉曲张。患有静脉曲张的孕妇在妊娠的最后三个月体重急剧增加。揭示了高血压的实际血压指标与生理标准的不一致。实施制定的物理治疗方案后,暴露出以下变化动态:与对照组相比,主组收缩压、舒张压和心率指标平均值下降(p>0.05)。在主组妇女中,肺活量增加了7.56%。主组孕妇体位由水平向垂直变化,直立试验的调节和反应类型归一化(-20.56%),与检查对照组比较,差异有统计学意义(p>0.05)。基于CIVIQ问卷数据的评估显示,主要组的应答者(关于身体状况的疼痛和投诉类别的指标)的生活质量的所有组成部分可能有所改善。因此,获得的结果使确定开发的物理治疗方案的有效性成为可能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PHYSICAL THERAPY OF PREGNANT WOMEN WITH PRIMARY MANIFESTATIONS OF VARICOSE DISEASE OF THE LOWER EXTREMITIES
As a result of the generalization of clinical experience, it has been proved that varicose disease of the lower extremities of pregnant women is defined as a polyetiological disease of the venous system. The high pathological incidence of varicose veins among pregnant women is caused by a number of factors. The consequence of such changes may be stagnation in the venous bed of the lower extremities. Therefore, women who have a history of primary manifestations of varicose veins of the lower extremities often have got problems during pregnancy and the postpartum period in the form of complications of symptoms leading to thrombophlebitis (inflammation of superficial veins). Timely started and implemented physical therapy allows relieving or completely eliminating the above symptoms of the disease of pregnant women, significantly improves the properties of blood circulation and the condition of the inner walls of vessels. The aim of the study is to assess the functional state of the body of women in the second and third trimester of pregnancy with primary manifestations of varicose veins of the lower extremities and the effectiveness of the physical therapy program. Methods and materials. 19 pregnant women with varicose veins, aged 22 to 29 years, from the second to third trimester of pregnancy participated in the study. Two groups were formed: the main number of 10 women (implemented measures of the developed physical therapy program, which included kinesiotherapy, therapeutic and electrophoresis) and a comparison group – 9 women (implemented standard physical therapy technique). The following methods were used during the research: 1) anthropometric examination; 2) physiological monitoring of functional indicators of the state of the cardiovascular system of women (pulsometry and tonometry with systematic registration of the indicators of systolic and diastolic blood pressure, heart rate; 3) functional diagnostics (active orthostatic test, spirometry); 4) clinical somatoscopy with participation; 5) assessment of the quality of life. Conclusions. In the process of different periods of pregnancy, the examined patients were diagnosed with primary varicose veins of the lower extremities. Pregnant women with varicose veins had an intensive increase of body weight in the last trimester of pregnancy. The inconsistency of the actual blood pressure indicators towards hypertension compared to the physiological norms was revealed. After the implementation of the developed physical therapy program, the following dynamics of changes were exposed: the average value of systolic and diastolic pressure and heart rate indicators of the main group decreased in contrast to the comparison group (p>0.05). Among the women of the main group, the vital capacity of the lungs increased by 7.56%. The normalization of the regulation and type of reaction of the orthostatic test with a change of body position from horizontal to vertical was observed among pregnant women of the main group (-20.56%) in contrast to the examined comparison group (p>0.05). The assessment based on the data of the CIVIQ questionnaire showed a probable improvement of all components of the quality of life of the respondents of the main group (indicator of the category of pain and complaints regarding the physical condition) of pregnant women. Thus, the obtained results make it possible to ascertain the effectiveness of the developed physical therapy program.
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