不同分娩方式对产妇产后早期盆底功能的影响

Effect of Different Delivery Modes on Dysfunction of Primipara Early Pelvic Floor

目的:探讨阴道顺产与剖宫产对初产妇产后早期盆底功能的影响。方法:150例产妇根据分娩方式分为阴道顺产组和剖宫产组,对所有产妇进行产后随访,依据相关妇科和手法检查进行盆底功能检测,并配合盆底功能诊断仪及国际咨询委员会尿失禁问卷进行调查,比较两组产妇分娩早期盆腔器官脱垂(POP)发生率、盆底肌力受损率及压力性尿失禁(SUI)发生率。结果:阴道顺产组阴道前壁脱垂率为93.33%,阴道后壁脱垂率为78.67%,子宫脱垂率为38.67%,明显高于剖宫产组的65.33%、26.67%和14.17%,两组比较差异有统计学意义(P<0.05);阴道顺产组盆底深层肌力受损率为33.33%,盆底浅层肌力受损率为52.00%,与剖宫产组的32.00%和50.67%比较差异无统计学意义(P>0.05);阴道顺产组SUI发生率与剖宫产组比较差异无统计学意义(P>0.05)。结论:剖宫产可以降低阴道和子宫脱垂的发生率,但并不能减少产后SUI的发生。

Objective： To investigate the effect of vaginal delivery and cesarean section on the pelvic floor function in the early stage of primipara. Methods： A total of 150 women were divided into vaginal delivery group and cesarean section group. All patients went through related gynecological examination,combined with pelvic floor function diagnosis instrument examination and International Advisory Committee on urinary incontinence questionnaire. Influence of mode of delivery was observed in the two groups of early pelvic floor dysfunction to compare incidence rate of pelvic organ prolapse（ POP）,pelvic floor muscle damage and stress urinary incontinence（ SUI）. Results： Anterior vaginal wall prolapse rate of vaginal delivery group was 93. 33%, the posterior vaginal wall prolapse rate was78. 67%,uterine prolapse rate was 38. 67%,significantly higher than that of cesarean section group65. 33%,26. 67% and 14. 17%（ P〈0. 05）; deep pelvic floor muscle damage rate of vaginal delivery group was 33. 33%,the damage rate of superficial pelvic floor muscle strength was 52%,no significant difference compared with cesarean section group 32% and 50. 67%（ P〈0. 05）; vaginal delivery group incidence rate of SUI were no statistical significance compared with cesarean section group（ P〈0. 05）. Conclusions： Cesarean section can effectively reduce the rate of vaginal and uterine prolapse,but do not reduce the occurrence of SUI.