Účinnost fyzioterapie na úlevu od bolesti a funkční zotavení po císařském řezu

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Autoři: Svitlana Ostafiichuk ¹ ; Nataliia Drohomyretska ¹ ; Olena Kusa ¹ ; Oksana Zhukuliak ¹ ; Olha Neiko ¹ ; Taras Kotyk ²
Působiště autorů: Department of Obstetrics and Gynecology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine ¹; Department of Human Anatomy, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine ²
Vyšlo v časopise: Ceska Gynekol 2025; 90(3): 204-211
Kategorie: Původní práce
doi: https://doi.org/10.48095/cccg2025204

Souhrn

Úvod: Počty císařských řezů (CS –⁠ cesarean section) celosvětově rostou, přičemž související poporodní komplikace jsou výrazně vyšší ve srovnání s vaginálním porodem. Řešení těchto komplikací pomocí optimalizovaného managementu a cílené fyzioterapie je klíčové pro zlepšení mateřských výsledků a kvality života. Cíl: Cílem této studie bylo zhodnotit účinnost fyzioterapie na úlevu od bolesti a obnovení funkční aktivity žen po CS. Materiál a metody: Do studie bylo zapojeno 91 pacientek, které byly přijaty do porodnické nemocnice pro elektivní CS. Kontrolní skupině (47 žen) byl poskytnut standardní předoperační a pooperační dohled. Intervenční skupina (44 pacientů) kromě standardní péče absolvovala fyzioterapii, která zahrnovala předoperační péči (fyzioterapeutický výcvik, edukační výcvik) a pooperační cvičení (dechové, oběhové a pánevní cvičení spolu s masáží pojiva). Výsledky po CS byly analyzovány po dobu 3 dnů. Výsledky: Nižší intenzita pooperačních bolestí a snazší chůze od 1. dne, nižší obtížnost při provádění funkčních činností 2. den (snazší otočení na lůžku a přechod do sedu), rychlejší obnova střevní motility v důsledku průchodu flatusu za 3,5 hod a defekace na 10 hod, snížená potřeba analgetik navíc 4,21krát (OR = 0,24; 95% CI 0,10–0,58; p = 0,02) a bylo zjištěno významné snížení doby trvání hospitalizace (OR = 0,24; 95% CI 0,09–0,57; p = 0,02). Závěr: Studie prokázala účinnost navrženého fyzioterapeutického programu v časném období po CS ve smyslu snížení bolesti a zlepšení obnovy funkční aktivity organizmu.

Klíčová slova:

císařský řez – fyzioterapie – porodnická rehabilitace – fyzioterapeutická edukace – syndrom pooperační bolesti

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ORCID of authors

S. Ostafiichuk 0000-0001-8301-814X

N. Drohomyretska 0000-0002-7371-2450

O. Kusa 0000-0002-8881-3756

O. Zhukuliak 0000-0002-8060-006X

O. Neiko 0000-0003-2408-2664

T. Kotyk 0000-0002-3585-2356

Submitted/Doručeno: 17. 12. 2024

Accepted/Přijato: 7. 3. 2025

Taras Kotyk, MD

Department of Human Anatomy

Ivano-Frankivsk National Medical University