产后妇女盆底肌损伤发生情况调查研究

Investigation of pelvic floor muscle injury in postpartum women

目的探讨产后妇女盆底肌功能情况并分析造成妇女产后盆底肌损伤的相关因素,为预防妇女因生产造成盆底肌损伤提供科学依据。方法以2019年1月至2020年11月在湖南省长沙市和株洲市各1家医院产科进行6~8周产后复查的产妇为研究对象进行资料收集及盆底肌力测定,采用描述流行病学分析方法进行盆底肌力异常情况分析,并采用单、多因素分析方法对产后妇女盆底肌异常影响因素进行分析。结果本研究共对1 628名产妇进行调查,年龄22~38岁,平均(29.68±5.36)岁;孕次1~5次,平均孕次(2.43±1.16)次;产次1~5次,以1~2次为主,占72.4%。检出1 142例产后6~8周产妇为盆底肌力异常,异常率为70.2%。年龄30~38岁(OR=3.766)、产次≥3次(OR=2.633)、阴道分娩(OR=7.478)、孕期增重过多(OR=1.597)及胎儿出生体重≥4 kg(OR=5.078)的产后妇女盆底肌力异常的风险较高。结论湖南省产后妇女盆底肌力异常率较高,年龄、产次、分娩方式、孕期增重及胎儿体质量是造成产妇产后发生盆底肌损伤的重要原因,应采取相应措施,降低产后妇女发生盆底肌损伤风险。

Objective To investigatethe pelvic floor muscle function of postpartum women and analyze the related factors of pelvic floor muscle injury,so as to provide scientific basis for preventing pelvic floor muscle injury caused by delivery. Methods From January 2019 to November 2020,the parturient who had undergone a 6-8 week postpartum re-examination in the obstetrics department of each hospital in Changsha City and Zhuzhou City,Hunan Province were selected as the research objects. The data were collected and the pelvic floor muscle strength was measured. The descriptive epidemiological analysis method was used to analyze the abnormality of pelvic floor muscle strength in postpartum women,and the univariate and multivariate analysis methodswere used to analyze its influencing factors.Results A total of 1 628 parturients were surveyed,aged 22-38 years,with an average age of(29.68±5.36)years.The graviditywas 1-5,with an average of(2.43 ± 1.16)times. Theparitywas 1-5,with 1-2 being the main ones,accounting for 72.4%.Among them,1 142 cases of parturient 6-8 weeks postpartum were found to have abnormal pelvic floor muscles strength,and the abnormality rate was 70.2%. Age 30-38 years(OR=3.766),with parity≥3(OR=2.633),vaginal delivery(OR=7.478),excessive weight gain during pregnancy(OR=1.597)and birth weight of newborns ≥4 kg(OR=5.078)postpartum women hada higher risk of abnormal pelvic floor muscles strength. Conclusion The abnormality rate of pelvic floor muscles strength in postpartum women in Hunan Province is relatively high. Age,parity,mode of delivery,weight gain during pregnancy,and weight of newborns are important causes of postpartum pelvic floor muscle injury. Corresponding measures should be taken to reducethe risk of pelvic floor muscle injury in postpartum women.