耻骨联合分离的康复与训练Rehabilitationandtrainingforpubicsymp.pptx

耻骨联合分离的康复与训练Rehabilitationandtrainingforpubicsymphysisdiastasis产后恢复培训课程PostpartumRecoveryTrainingCourse

目录（Contents）耻骨联合的解剖（Anatomyofpubicsymphysis）产后耻骨联合分离症（Postpartumpubicsymphysisdiastasis）耻骨联合分离的治疗（Treatmentofpubicsymphysisdiastasis）耻骨联合分离的检查（Examinationofpubicsymphysisdiastasis）预防措施（Preventivemeasures）

产后耻骨联合分离症(Postpartumpubicsymphysisdiastasis)什么是产后耻骨联合分离症？（Whatispubicsymphysisdiastasis?）耻骨联合分离主要见于妊娠后期和产后妇女，由于松弛素水平的影响使耻骨联合韧带松弛，怀孕后期姿势不当，分娩时急产、巨大儿，或用力不当等都会造成耻骨联合面分离，不能恢复到正常位置，耻骨联合间隙分离超过1厘米，即可诊断为耻骨联合分离。(Pubicsymphysisdiastasisismainlyseeninwomeninlatepregnancyandafterchildbirth,duetoloosenedpubicsymphysisligamentbytheinfluenceofrelaxinlevel,improperpostureinlatepregnancy,emergencydelivery,macrosomia,orimproperforceduringdeliverycancauseseparationofpubicsymphysis,whichcannotberestoredtonormalposition,andseparationofpubicsymphysisgapmorethan1cmcanbediagnosedaspubicsymphysisdiastasis.)

临床表现（Clinicalmanifestation）耻骨联合处疼痛，在负重、翻身时加重，可合并腰背部、腹股沟区疼痛。(Painatthesymphysispubis,whichisaggravatedduringweightbearingandturning,andmaybecombinedwithpaininthelowerbackandgroinarea.行走困难，重心移动缓慢，步态摇摆或呈鸭步。(Difficultwalking,withslowweightshiftandawobblyorduckygait.)阳性体征：局部压痛与叩击痛明显，髋关节外展、外旋活动受限，骨盆挤压试验、骨盆分离试验、4字试验及内收肌抗阻试验阳性。(Positivesigns:obviouslocaltendernessandpercussionpain,limitedhipabductionandexternalrotation,positivepelviccompressiontest,pelvicdistractiontest,figure-4testandadductorresistancetest.)(Postpartumpubicsymphysisdiastasis)产后耻骨联合分离症

临床表现（Clinicalmanifestation）辅助检查：(Examination)x线:骨盆正位片判断耻骨联合分离间距大于1厘米。(X-ray:posteroanteriorpelvicfilmtocomfirmtheseparationofpubicsymphysisisgreaterthan1cm;)CT:关节是否存在炎症。(CT:showwhetherthereisinflammationofthejoint;)MR:清楚显示周围软组织的情况。(MR:clearlyshowtheconditionofsurroundingsofttissues.)超声:清晰显示耻骨联合及其周围软组织的解剖结构。(Ul