不同分娩方式与产后压力性尿失禁的关系

The relation of clinical discuss between different delivery mode and postpartum stress urinary incontinence

目的：探讨不同分娩方式与产后压力性尿失禁的关系。方法分析中山市东凤人民医院妇产科2012年2月~2014年10月妇产科分娩的产妇1200例临床资料，依据分娩方式不同进行分组，阴道分娩组600例和剖宫产组600例。观察两组产妇产后排尿状况评分、肌力评分情况、UVJ-M值、尿道旋转角度、压力性尿失禁发生率及尿垫试验阳性情况。结果剖宫产组产妇产后排尿状况评分低于阴道分娩组，肌力评分高于阴道分娩组，差异均有统计学意义（t=27.79、18.91，P＜0.05）；剖宫产组产妇产后UVJ-M值低于阴道分娩组，尿道旋转角度高于阴道分娩组，，差异均有统计学意义（t=36.31，27.11，P＜0.05）；剖宫产组产妇产后压力性尿失禁发生率低于阴道分娩组，差异有统计学意义（χ2=13.36，P＜0.05）；剖宫产组产妇产后尿垫试验阳性率低于阴道分娩组，差异有统计学意义（χ2=13.36，P＜0.05）。结论阴道分娩对于盆底神经和肌肉造成损伤，是发生压力性尿失禁的高危因素，应注意盆底组织保护。

Objective To approach relation between different delivery mode and postpartum stress urinary incontinence. Methods The clinical data of 1200 cases from February 2012 to October 2014 delivery in Department of Gynaecology and Obstetrics, Dongfeng People＆#39;s Hospital were analyzed, and they were divided into two groups： vaginal delivery group and caesarean section group, with 600 cases in each group. The postpartum urine condition and muscle strength grade of two groups were detected, the UVJ-M and urethral rotation angle, incidence of postpartum stress urinary in-continence, postpartum urine pad test positive rate of two groups were observed. Results The postpartum urine condi-tion of caesarean section group was lower than the vaginal delivery group, muscle strength grade was higher than the vaginal delivery group, the differences were statistically significant （t=27.79, 18.91, P〈 0.05）; the UVJ-M of caesarean section group was lower than the vaginal delivery group, urethral rotation angle was higher than the vaginal delivery group, the differences were statistically significant （t=36.31, 27.11, P〈0.05）;the incidence of postpartum stress urinary incontinence of the caesarean section group was lower than the vaginal delivery group, the difference was statistically significant （χ2=13.36, P〈0.05）;postpartum urine pad test positive rate of the caesarean section group was lower than the vaginal delivery group, the difference was statistically significant （χ2=13.36, P〈0.05）. Conclusion The pelvic nerves and muscles by vaginal delivery are injuried, which is high risk factor of happening postpartum stress urinary incontinence, which should be pay attention to pelvic floor organization of protection.