产后6~8周妇女盆底肌筋膜疼痛现状及影响因素分析

Incidence of myofascial pelvic pain in postpartum women 6-8 weeks after delivery and its influencing factors

关键词:  产后妇女  盆底肌筋膜疼痛  影响因素  盆底肌筋膜疼痛触发点

Key words:  postpartum women  myofascial pelvic pain  influencing factors  myofascial trigger points

摘要:

目的 调查产后妇女盆底肌筋膜疼痛（myofascial pelvic pain, MFPP）现状并探讨可能的影响因素。方法 选取2021年8月—2022年3月在上海交通大学医学院附属同仁医院产后68周检查的873例妇女为研究对象，经知情同意后调查其MFPP的发病情况，包括社会人口学特征、孕期增重、分娩次数、分娩方式、临床相关症状和盆底肌筋膜触痛情况及评分。通过卡方检验、多因素logistic回归分析MFPP的可能影响因素。结果 873例产妇参加本研究，261例诊断为MFPP，发病率29.9%。年龄≥35岁的产妇MFPP的风险高于<25岁的产妇（OR=3.03，95%CI: 1.217.58）；分娩次数≥2次的产妇，MFPP的风险高于分娩1次产妇（P<0.05）；MFPP产妇平均孕期增重（12.83±4.46） kg，显著高于非MFPP产妇（12.16±4.42 kg）差异有统计学意义（P=0.044）。结论 产后MFPP发病率较高，产后检查需重视盆底肌肉触诊，以早期识别该病，选择合适的康复治疗方案。产妇年龄≥35岁、分娩次数≥2次、孕期增重多是MFPP的危险因素。据此，应加强适龄生育、孕期合理营养、体育锻炼和控制体重增长的宣教和指导。

Abstract:

Objective To investigate the incidence of myofascial pelvic pain(MFPP) in postpartum women and to explore its influencing factors. Methods A total of 873 women who underwent postpartum examination 6-8 week after delivery at Tongren Hospital Affiliated to Shanghai Jiao Tong University School of Medicine during August 2021 to March 2022 were enrolled in the study. The information of MFPP, socio-demographic characteristics, weight gain during pregnancy, delivery times, delivery methods，clinical symptoms，pelvic floor myofascial tenderness and scoring was collected. The influencing factors of MFPP were analyzed by Chi-square test and multiple logistic regression. Results Among 873 women MFPP occurred in 261 cases with an incidence rate of 29.9%. Women aged ≥35 have a higher risk of MFPP compared to women aged<25（OR=3.03, 95%CI: 1.21-7.58）and women with a parity of ≥2 had a higher risk of MFPP compared to those with one delivery (P<0.05). The average gestational weight gain in MFPP cases [(12.83±4.46) kg] was significantly higher than in non-MFPP cases [(12.16±4.42)] kg, with a statistically significant difference (P=0.044). Conclusion The incidence of M`FPP is high in postpartum women, age ≥35 years, parity ≥2 and more weight gain during pregnancy are risk factors for MFPP. Therefore, we should emphasize the importance of pelvic floor muscle palpation during postpartum examinations to early identify the condition and select appropriate rehabilitation treatments. Education and guidance on age-appropriate childbirth, proper nutrition during pregnancy, physical exercise and weight management should be reinforced.