《中国康复理论与实践》

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (11): 1346-1350.doi: 10.3969/j.issn.1006-9771.2021.11.017

• 临床研究 • 上一篇    下一篇

骨盆环整体理论指导下产后耻骨联合分离的治疗效果

王琰,李勇强,高伟鹏,米慧,刘风,郑遵成()   

  1. 泰安市中心医院,山东泰安市 271000
  • 收稿日期:2021-03-22 修回日期:2021-08-09 出版日期:2021-11-25 发布日期:2021-12-03
  • 通讯作者: 郑遵成 E-mail:zhengzc650211@126.com
  • 作者简介:王琰(1982-),女,汉族,山东青岛市人,硕士,主治医师,主要研究方向：孕产康复与肌电图。|郑遵成,男,硕士,主任医师。
  • 基金资助:
    泰安市科技发展计划项目(2018NS0203)

Holistic Pelvic Ring Concept in Treatment of Postpartum Pubic Symphysis Diastasis

WANG Yan,LI Yong-qiang,GAO Wei-peng,MI Hui,LIU Feng,ZHENG Zun-cheng()   

  1. Tai'an Central Hospital, Tai'an, Shandong 271000, China
  • Received:2021-03-22 Revised:2021-08-09 Published:2021-11-25 Online:2021-12-03
  • Contact: ZHENG Zun-cheng E-mail:zhengzc650211@126.com
  • Supported by:
    Tai'an Science and Technology Development Plan(2018NS0203)

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摘要：

目的 观察在骨盆环整体理论指导下,产后耻骨联合分离患者进行悬吊下骨盆三维调整后骨盆带固定的治疗效果。方法 2018年2月至2020年2月,本院产科分娩后耻骨联合分离的产妇30例,行骨盆环评估,根据评估结果,悬吊后三维调整骶髂关节和耻骨联合解剖复位,骨盆带固定6~8周。彩超监测复位后耻骨联合愈合,摘除骨盆带2周后复查骨盆X线;治疗前、摘除骨盆带时、摘除骨盆带2周后,采用疼痛视觉模拟评分(VAS)、改良Barthel指数(MBI)进行评定。结果 摘除骨盆带2周后,患者VAS和MBI评分,以及耻骨联合分离距离、耻骨联合上缘差、髂骨翼宽度差、闭孔横径差及纵径差均较治疗前改善(t > 2.509, P < 0.05);其中VAS评分和MBI评分还较摘除骨盆带时改善(|t| > 2.854, P < 0.05),耻骨联合分离距离较摘除骨盆带时稍有增宽(t = 2.319, P < 0.05),但仍在正常值范围内。结论 在骨盆环整体理论指导下治疗产后耻骨联合分离,能基本恢复骨盆解剖结构,避免出现代偿运动模式,提高后期生活质量。

关键词: 产后耻骨联合分离, 骨盆环, 骨盆三维调整

Abstract:

Objective To observe the effect of pelvic band fixation with three-dimensional adjustment of suspended pelvis on patients with pubic symphysis diastasis under the holistic pelvic ring concept.Methods From February, 2018 to February, 2020, 30 parturients with pubic symphysis diastasis were evaluated pelvic ring. They accepted three-dimensional adjustment of pelvis with suspension to restore the anatomical reduction of sacroiliac joint and the symphysis pubis according to the evaluation, and were fixed with pelvic band for six to eight weeks. The pubic symphysis union was monitored with color ultrasonography. They were reviewed with pelvic X-ray two weeks after removal of pelvic band, and assessed with Visual Analogue Scale (VAS) for pain and modified Barthel Index (MBI) before treatment, immediately after removal of the pelvic band and two weeks after removal of the pelvic band, while the pelvic ring structure was measured.Results The scores of VAS and MBI improved two weeks after pelvic band removal compared with those before treatment, as well as distance of pubic symphysis separation, upper margin difference of pubic symphysis, width difference of iliac wings, transverse and longitudinal diameter difference of obturator foramens (t > 2.509, P < 0.05). However, the scores of VAS and MBI improved two weeks after pelvic band removal compared with those immediately after removal of the pelvic band (|t| > 2.854, P < 0.05), while the distance of pubic symphysis separation increased (t = 2.319, P < 0.05), still in the normal reference value.Conclusion Correcting the post-partum pubic symphysis diastasis under the holistic pelvic ring concept can restore the anatomical structure of the pelvis, avoid the compensatory movement pattern, and improve the daily living in the later time.

Key words: post-partum pubic symphysis diastasis, pelvic ring, three-dimensional adjustment of pelvis