产后盆底功能障碍性疾病与盆底肌收缩力及其相关因素分析

Correlation of Postpartum Pelvic Floor Dysfunction with Contractility of Pelvic Floor Muscles and Related Factors

目的:探讨产后盆底功能障碍性疾病(PFD)与盆底肌收缩力的关系及其相关因素。方法:选择产后42~60天有产后尿失禁(UI)或盆腔器官脱垂(POP)的妇女为研究组(102例),其中UI患者66例(UI组),POP患者36例(POP组);另选择同期产后复查的正常产妇100例为对照组。对研究组和对照组的一般情况进行问卷调查,并采用肌电图描记法对UI组、POP组和对照组的盆底肌力进行评估。结果:1研究组的年龄、分娩前体重指数(BMI)、新生儿体重、阴道分娩率及有腹压增高史率明显高于对照组(P<0.05;P<0.01)。2研究组肌电图持续收缩值和快速收缩值均明显低于对照组(P<0.01)。3研究组中UI组的快速收缩值明显低于POP组和对照组(P<0.01),研究组中POP组的持续收缩值明显低于UI组和对照组(P<0.01)。结论:产后PFD的发生可能与年龄、分娩前BMI、新生儿体重、阴道分娩等因素有关;产后PFD与盆底肌收缩力下降有关,其中POP可能与Ⅰ类肌力下降有关,而UI可能与Ⅱ类肌力下降有关。

Objective：To analyze the correlation of postpartum pelvic floor dysfunction with the contractility of pelvic floor muscles and related factors. Methods：A cohort of 102 patients in postpartum 42 -60 days with symptoms of pelvic floor dysfunction,including 66 of postpartum urinary incontinence（UI） and 36 of pelvic organ prolapsed（POP） ,were recruited. 100 postpartum women with normal pelvic floor function were^recruited as a control group. A questionnaire survey was conducted for the general situation of the subjects. The correlation of postpartum pelvic floor dysfunction and contractility of pelvic floor muscles was determined through the electromyographic recording of pelvic floor,measuring the sustained and rapid contractility as the function of pelvic floor class I and II muscle,respectively. Results：①The age,predelivery body mass index, newborn baby weight, vaginal birth rate and a history of abdominal pressure in the study group were significantly higher than those in the control group（ P 〈 0.05 ; P 〈 0.01 ）. ②Both the sustained and rapid contractilities of pelvic floor muscle in the study group were significantly lower than those in the control group（ P 〈0.01 ）. ③The rapid contractility in UI patients was significantly lower than that in POP patients and control group（ P 〈 0. 01 ）, and the sustained contractility in POP patients was significantly lower than that in UI patients and control group（ P 〈 0.01 ）. Conclusions： Age, pre-delivery BMI, newborn body weight, and vaginal delivery, may be related factors of postpartum pelvic floor dysfunction. The postpartum pelvic floor dysfunction may be associated with the declined contractility of pelvic floor muscle, especially the POP with class I muscle, and the UI with class II muscle.