产后早期盆底功能恢复情况194例分析

Analysis of early pelvic function recovery condition after delivery in 194 puerperae

目的探讨女性产后早期盆底功能恢复的情况及特点。方法选择在深圳市人民医院产科住院分娩,且于2010年10月至11月在产科门诊就诊的产后6～8周产妇194例,由专人负责行盆底功能检查,包括常规妇科检查、手测盆底肌力评定及盆腔器官脱垂定量评分,有漏尿史者行尿垫实验。结果 194例产妇中,发生盆腔脏器脱垂者146例(75.26%),发生产后压力性尿失禁42例(21.65%)。发生盆腔脏器脱垂者均有阴道前壁脱垂,其中Ⅰ度脱垂占66.44%(97/146),Ⅱ度脱垂占33.56%(49/146);阴道前壁脱垂合并后壁脱垂占4.79%(7/146),均为Ⅰ度脱垂;阴道前壁脱垂合并子宫脱垂占11.64%(17/146),均为Ⅰ度脱垂;阴道前壁脱垂同时合并阴道后壁脱垂和子宫脱垂1例(0.68%),为Ⅰ度脱垂。结论产后早期盆底功能障碍性疾病发生率高;以阴道前壁脱垂和压力性尿失禁为高发,主要表现为轻型病变;应重视产后早期盆底功能康复,以提高妇女生活质量。

Objective To discuss the situation and feature of early pelvic function recovery after delivery.Methods One hundred and ninety-four puerperae after delivery 6-8 weeks who outpatients in department of obstetrics from 2010 october to november and inpatient delivery in department of obstetrics in Shenzhen People′s Hospital were selected,pelvic function was checked by the specialist,including conventional gynaecological check-up,pelvic floor muscle strength assessment by hand and pelvic organ prolapsed quantitative score,the urine mat experiment made for had history of urinary leakage person.Results Among the 194 puerperae,146 puerperae（75.26%） had pelvic organ prolapse,42 puerperae（21.65%） had postpartum stress urinary incontinence.All the patients who had pelvic organ prolapse suffered from anterior vaginal wall prolapse,in which 66.44%（97/146） were of grade Ⅰ,33.56%（49/146） were of grade Ⅱ.Anterior vaginal wall prolapse combined with posterior vaginal wall prolapse accounted for 4.79%（7/146）,all were grade Ⅰ;Anterior vaginal prolapse combined with uterine prolapse accounted for 11.64%（17/146）,all were grade Ⅰ.One puerperae（0.68%） had anterior vaginal wall prolapse combined with posterior vaginal wall prolapse and uterine prolapse,for Ⅰ degree of prolapse.Conclusion The incidence of female pelvic floor dysfunction is high on the early postpartum,especially anterior vaginal wall prolapse and stress urinary incontinence.Luckily,most of them are mild.Therefore,emphasis should be put on pelvic floor reeducation on the early postpartum,in order to improve quality of their lives.