摘要
目的:探讨不同分娩方式对初产妇早期盆底功能障碍的影响。方法:选择产后6～8周检查时无子宫出血的145例初产妇,分阴道分娩组90例,剖宫产组55例,由专门培训的人员经妇科检查+手法检测+诊断仪诊断盆底器官脱垂及盆底肌力分级,专人询问及填写孕期及产后的尿失禁问卷调查表,并对结果进行统计学分析。结果:剖宫产组不同程度阴道前壁脱垂、后壁脱垂,子宫脱垂与阴道分娩组比较,差异有统计学意义(P<0.05)。剖宫产组盆底深层肌力受损17例(30.9%),浅层肌力受损24例(43.6%),阴道分娩组盆底深层肌力受损34例(37.8%),浅层肌力受损46例(51.1%),两组比较差异无统计学意义(P>0.05)。孕期压力性尿失禁(SUI)发生共41例,患病率28.3%,其中剖宫产18例(32.7%),阴道分娩23例(25.6%),两组比较差异无统计学意义(P>0.05)。产后SUI27例,患病率18.6%,其中剖宫产10例(18.2%),阴道分娩17例(18.9%),两组比较差异无统计学意义(P>0.05)。产妇年龄、新生儿体重是盆底器官脱垂的高危因素,剖宫产是保护因素,盆底肌力的受损与分娩方式及产科因素无相关性。结论:与阴道分娩比较,剖宫产可以降低子宫、阴道脱垂的发生,但并不减少产后SUI的发生。
Objective： To investigate the effect of different delivery modes and related obstetric factors on the short-term dysfunction of the pelvic floor. Methods： One hundred and forty-five healthy women were inter- viewed at 6 to 8 weeks postpartum,with 90 women in the vaginal delivery group and 55 women in the elective cesarean section group. Gynecologic examination, pelvic floor muscle contraction by the finger guide and measurement of pelvic floor muscles function by special diagnostic apparatus（ PHENIX U8 Guangzhou Shan- shan company provided ）were used for the diagnosis of pelvic organ prolapse and pelvic floor muscle strength grading as well as questionnaire on stress urinary incontinence performed by special staff. Results： There were significant differences statistically on the prevalence of anterior vaginal wall prolapse, posterior wall prolapse and uterine prolapse between elective cesarean section group and vaginal delivery group （ P 〈 0.05）. In elective cesarean section group,17 cases （30.9%） had the deep muscle strength lesion of pelvic floor and 24 cases （43.6%） had the shallow muscle strength lesion of pelvic floor. However, in vaginal deliv- ery group 34 cases （37.8%） and 46 cases （51.1% ） had the above dysfunction abnormalities respectively. Two groups showed no significant differences statistically （ P 〉 0.05）. Total number of urinary incontinence during pregnancy was 41 ,the prevalence was 28.3%. Among these cases, 18 cases were in elective cesare- an section group accounting for 32.7% ,23 cases were in vaginal delivery group accounting for 25.6% ,there was no significant difference statistically （ P 〉 0.05）. Total number of postpartum urinary incontinence was 27,the prevalence was 18.6%. Among these cases,10 cases were in elective cesarean section group ac- counting for 18.2% ,17 cases were in vaginal delivery group accounting for 18.9% ,there was no significant difference statistically （ P 〉 0.05）. Maternal age and infant birth weight were risk factors for pelvic organ pro- lapse （ P 〈 0.05）, Cesarean section was a protective factor （ P 〈 0.05）. Conclusions： Compared with vagi- nal delivery, cesarean section can reduce the uterus and vaginal prolapse, but it can not reduce the incidence of postpartum urinary incontinence, Long-term effect of fetus gravity and hormones may be the main causes of dysfunction of the pelvic floor.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2012年第9期785-788,共4页
Journal of Practical Obstetrics and Gynecology
关键词
分娩方式
盆底功能障碍
尿失禁
压力性
DeliverY
Pelvic floor dysfunction
UrinarY incontinence
Stress
