不同分娩方式与产后盆底肌力变化的相关性分析

The relations between two different delivery methods and the post-partum pelvic floor muscle strength

目的观察不同分娩方式对产后盆底肌力变化的影响。方法将56例初产妇根据分娩方式不同分为择期剖宫产组（n=34例）和自然分娩组（n=22例）。分别于分娩后1、3个月对所有产妇进行盆底功能障碍、产后尿失禁等随访调查，并对所有产妇进行盆底肌力检测。结果产后1个月、3个月择期剖宫产组产妇中分别有4例（11．8％）、3例（8．8％）发生盆底功能障碍，自然分娩组产妇中分别有8例（36．4％）、6例（27．3％）发生盆底功能障碍；择期剖宫产组产妇中分别有3例（8．8％）、2例（5．9％）发生产后尿失禁，自然分娩组产妇中分别有5例（22．7％）、4例（18．2％）发生产后尿失禁；择期剖宫产组产妇中盆底肌力检测≥3分者有19例（55．8％）、25例（77．5％），自然分娩组产妇中≥3分者有8例（36．4％）、10例（45．4％）。两组差异均有统计学意义（均P〈0．05）。结论相对于自然分娩，择期剖宫产术可降低盆底功能障碍、产后尿失禁发生率，增加产后盆底肌力。

Objective To study the effect of two different delivery methods on the post-partum pelvic floor muscle strength. Methods 56 primipara were divided into two groups according to different delivery methods ,34 prlmipara took elective caesarean section,while 22 took natrual delivery. In 1 ~ 6 months after childbirth, they were re- spectively undertaken pelvic floor dyssynergia and urinary incontinence after childbirth scoring, then carried out pelvic muscle testing. Results The elective caesarean section group had 4 and 3 primiparas who were pelvic floor dyssyner- gia ,the rate of pelvic floor dyssynergia of elective caesarean section group was 11.8% and 8. 882% ,and 8 and 6 pri- miparas of natrual delivery had pelvic floor dyssynergia, the rate of pelvic floor dyssynergia of natrual delivery group was 36.4% and 27.3% at one and three months post-partum seperately,the rate of pelvic floor dyssynergia between elective caesarean section group and natrual delivery group was statistically different（ P 〈 0.05）. The elective caesare- an section group had 3 and 2 primiparas who were urinary incontinence after childbirth, the rate of urinary inconti- nence after childbirth of elective caesarean section group was 8.8% and 5.9% ,and 5 and 4 primiparas of natrual de- livery had urinary incontinence after childbirth, the urinary incontinence after childbirth of natrual delivery group was 27.7% and 18.2%, the rate of urinary incontinence after childbirth between elective caesarean section group and natrual delivery group was statistically different（ P 〈 0.05 ）. The elective caesarean section group had 19 and 25 pri- miparas who got ≥3 score in pelvic floor testing,take up 55.8% and 77.5% in the elective caesarean section group, the natrual delivery group had 8 and 10 primiparas who got ≥3 score in pelvic floor testing,take up 36.4% and 45.4% in the natrual delivery group,the rate of ≥3 score in pelvic floor testing of elective caesarean section group was much more than natrual delivery group, and it was statistically different （ P 〈 0.05 ）. Conclusion Relative to natrual delivery ,the rate of pelvic floor dyssynergia and urinary incontinence after childbirth was much less in elective caesarean section, and the pelvic floor testing score was more in elective caesarean section.