摘要
目的探讨会阴侧切对初产妇产后早期盆底康复及盆底功能障碍发生率的影响。方法选取2018年1月至2019年11月浙江大学医学院附属妇产科医院宁海分院接收的自然分娩的初产妇90例,按照分娩中是否行会阴侧切分为两组,对照组(未行会阴侧切)45例,研究组(行会阴侧切)45例。观察两组盆底功能障碍发生率、肌纤维肌力指标、相关各项指标,Ⅰ类肌纤维疲劳度、Ⅱ类肌纤维疲劳度及阴道动态压力。结果与对照组比较,产后研究组盆底功能障碍发生率高(P<0.05);治疗后两组肌纤维肌力均有所改善(P<0.05),但与对照组比较,研究组改善程度低(P<0.05);治疗后与对照组比较,研究组Ⅰ类、Ⅱ类肌纤维疲劳度高,阴道动态压力低(P<0.05)。结论在初产妇分娩中行会阴侧切会在一定程度上增加盆底功能障碍的发生率,且会影响早期盆底康复的效果,因此在后期临床中应当降低会阴侧切率,必要侧切后及时进行盆底康复的干预治疗。
Objective To explore the effect of perineal lateral incision on the early postpartum pelvic floor rehabilitation and incidence of pelvic floor dysfunction in primiparas.Methods A total of 90 primiparas who had natural delivery in Ninghai Branch of Women′s Hospital School of Medicine Zhejiang University from January 2018 to November 2019 were selected.They were divided into two groups according to whether they underwent lateral perineal incision during delivery.There were 45 patients in the control group(without lateral perineal incision)and 45 patients in the study group(with lateral perineal incision).The incidence of pelvic floor dysfunction,muscle strength index of muscle fiber,related indexes,fatigue degrees of typeⅠandⅡmuscle fibers,and dynamic vaginal pressure were observed and compared between the two groups.Results Compared with the control group,the study group had a higher incidence of pelvic floor dysfunction(P<0.05).After treatment,the muscle strength indexes of muscle fiber were improved in both groups(P<0.05),and the improvement in the study groups was lower than that in the control group(P<0.05).After treatment,compared with the control group,the study group had higher fatigue degrees of typeⅠandⅡmuscle fibers and lower vaginal dynamic pressure(P<0.05).Conclusion Perineal lateral incision increases the incidence of pelvic floor dysfunction to a certain extent and affects early pelvic floor rehabilitation in primiparas.The rate of perineal lateral incision should be reduced in clinical practice.If lateral perineal incision is needed,interventions for pelvic floor rehabilitation should be performed in time.
作者
史斌
沈平绒
叶小芳
邵佩
岑瑾
SHI Bin;SHEN Pingrong;YE Xiaofang;SHAO Pei;CEN Jin(Department of Gynecology,Ninghai Branch of Women′s Hospital School of Medicine Zhejiang University,Ninghai Maternal and Child Health Hospital,Ninghai315600,China)
出处
《中国现代医生》
2022年第2期72-75,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2019KY645)。
关键词
会阴侧切
自然分娩
妊娠
初产妇
早期盆底康复
盆底功能障碍
Lateral perineal incision
Natural delivery
Pregnancy
Primipara
Early pelvic floor rehabilitation
Pelvic floor dysfunction
