妊娠期间下肢的功能和解剖改变

Khryshchanovich V. Y., Mozheyko L. F., Skobeleva N. Y.
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摘要

目标。评估孕妇下肢功能和解剖改变的患病率,并讨论其可能的原因和目前的治疗建议。患者和方法。为了评估下肢的变化,100名孕龄为38.5±1.3周的孕妇连续参与了一项个人直接问卷调查。患者年龄19 ~ 43岁,平均31.4±5.3岁。妊娠和分娩次数分别为2.4±1.5次和1.8±1.2次。调查问卷的人口统计部分包括怀孕前和产前的年龄、身高、体重和鞋码、医疗和产科史以及体育活动等信息。原始问卷的临床部分包含与皮肤、血管、神经和肌肉骨骼疾病评估相关的部分。结果。在怀孕期间,女性的体重从66.6±14.8 kg增加到78.8±14.6 kg,休闲鞋的尺码从37.9±1.3增加到38.2±1.2,增加了0.3 cm(27%的观察)。超过一半(57%)的研究参与者称他们的日常体育活动水平为中等。研究表明,85%的孕妇报告下肢功能或解剖改变,其中皮肤病变53%,血管病变49%,周围神经病变22%,肌肉骨骼病变69%。结论。妊娠期的特点是孕妇的内分泌、免疫和代谢发生重大变化,从而引发一系列生理和病理状况。建立下肢症状和综合征的患病率将为建立有效的下肢不良反应的医学预防和治疗体系提供基础。
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FUNCTIONAL AND ANATOMICAL CHANGES IN THE LOWER EXTREMITIES DURING PREGNANCY
Objective. To evaluate the prevalence of functional and anatomical changes in the lower extremities of pregnant women and discuss their possible causes and current therapeutic recommendations. Patients and methods. To assess changes in the lower extremities, 100 pregnant women at 38.5±1.3 weeks of gestation age were consecutively enrolled in an individual direct questionnaire. Patients’ ages ranged from 19 to 43 years (mean 31.4±5.3). The number of previous pregnancies and labours were 2.4±1.5 and 1.8±1.2 respectively. The demographic part of the questionnaire included information on age, height, body weight and shoe size before pregnancy and antepartum, medical and obstetric history and physical activity. The clinical section of the original questionnaire contained sections related to the assessment of skin, vascular, neurological and musculoskeletal disorders. Results. During pregnancy, there was an increase in women’s body weight from 66.6±14.8 kg to 78.8±14.6 kg and an increase in casual shoe size by 0.3 cm from 37.9±1.3 to 38.2±1.2 (in 27% of observations). More than half (57%) of study participants described their level of daily physical activity as moderate. The study showed that 85% of pregnant women reported functional or anatomical changes in the lower extremities, which included dermatological changes in 53%, vascular changes in 49%, peripheral nerves changes in 22%, and musculoskeletal changes in 69%. Conclusion. The gestational period is characterised by significant endocrine, immunological and metabolic changes of the pregnant woman, which provokes a range of both physiological and pathological conditions. Establishing the prevalence of lower limb symptoms and syndromes will provide the basis for developing an effective system of medical prevention and treatment of undesirable lower extremities effects.
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