不同分娩方式对初产妇产后性功能影响的临床对比研究

Impact of different methods of delivery on the postpartum sexual function of primipara

目的:探究分析顺产、会阴侧切与剖宫产三种分娩方式对初产妇产后性功能的影响。方法:选择2011年3月至2014年2月来我院分娩的300例初产妇,按照其分娩方式分为顺产组80例,会阴侧切组105例,剖宫产组115例。分别在产后2个月、5个月以及8个月对所有初产妇进行性功能状况调查,分析比较三组患者性功能状况的差异性。结果:产后2个月、5个月、8个月时的性功能障碍发生率相比,三组患者均在产后2个月后发生性功能障碍的比例最高,产后5个月、8个月后均明显降低,具有明显差异性(P<0.05)。NVD/epi组与其他两组比较,产后2个月、5个月、8个月时的性功能障碍发生率均高于顺产组和剖宫产组,具有显著性差异(P<0.05);三组产妇在产后2个月和5个月的性功能评分中,其顺产组、剖宫组的总分分别与会阴侧切组相比具有统计学意义(P<0.05),而顺产组与剖宫组相比差异并不明显(P>0.05),8个月后各组评分则均无统计学意义(P>0.05);在产后2个月后,顺产组与剖宫组的性生活恢复的比例分别为75.0%、73.9%,与会阴侧切组相比较高,具有明显差异性(P<0.05),产后5个月顺产组与剖宫组的性生活恢复的比例分别为91.2%、89.6%,与会阴侧切组相比较高,具有明显差异性(P<0.05),产后8个月后三组患者恢复性生活的比例均较高,组间比较无差异性(P>0.05)。结论:顺产分娩方式使初产妇患者发生性功能障碍的比例最低,恢复性生活的比例最高,性功能水平最高,其次为剖宫分娩,而会阴侧切组对初产妇产后性功能障碍、性功能水平影响相对较大,因此建议初产妇选择顺产进行分娩。

Objectives：To explore the impact of nature birth,episiotomy and cesarean on the postpartum sexual function of primipara.Methods：The 300 primipara in our hospital from March 201 1 to February 201 4 were selected and divided into three groups according to their mode of delivery,i.e.nature birth group （80 cases）,epi-siotomy group （1 05 cases）,and cesarean section group （1 1 5 cases）.Their sexual functions were surveyed 2 months,5 months and 8 months after,to analyze and compare the differences among the three groups.Results：The occurrence rate of sexual dysfunction was the highest 2 months after delivery,with significant difference from those at 5 or 8 months after delivery （P 〈0.05）.Compared with the other two groups,the incidence rate of sexual dys-function in the NVD /epi group was much higher at 2,5 and 8 months after delivery,with significant differences （P 〈0.05）.The sexual function scores of nature birth group and cesarean group at both 2 and 5 months after deliv-ery were higher than that of the episiotomy group,with statistically significance （P 〈0.05）,and difference between the first two groups was not significant （P 〉0.05）,so as the difference among the three groups 8 months after deliv-ery （P 〉0.05）.At two months after delivery,the recovery rate of sexual function in the nature birth group and ce-sarean group were 75.0% and 73.9% respectively,higher than that in the episiotomy group,with significant differ-ence （P 〈0.05）;the recovery rate at 5 months after delivery were 91 .2% and 89.6 % respectively,higher than the episiotomy group,with significant difference （P 〈0.05）;the recovery rate at 8 months after delivery was not significantly different among the three groups （P 〉0.05）.Conclusion：Primipara adopting nature birth delivery has the lowest incidence rate of sexual dysfunction,highest level of sexual function and recovery rate,followed by cesarean section and episiotomy orderly.Therefore,nature birth is a better choice for primipara.