会阴侧切对初产妇产后盆底功能影响的临床研究

Impact of episiotomy on the postpartum pelvic floor function in primary pregnancy

目的探讨会阴侧切对初产妇产后盆底功能的影响。方法选择756例阴道分娩会阴侧切的初产妇为研究组,另外选择756例剖宫产术的产妇为对照组。比较两组产后42天压力性尿失禁、盆腔脏器脱垂的发生率与盆底肌力筛查结果。结果研究组产后压力性尿失禁比率(9.13%)显著高于对照组(3.31%);盆腔脏器脱垂II期发生率(19.31%)显著高于对照组(7.41%);会阴疼痛的发生率(6.48%)显著高于对照组(1.59%);I类肌纤维肌力异常发生率与I类肌纤维疲劳度异常的发生率(20.89%,92.72%)显著高于对照组(13.50%,75.67%);阴道动态压力异常的发生率(75.79%)显著高于对照组(49.47%)。差异均有显著性(P<0.05)。结论会阴侧切会导致患者盆底功能受到影响,初产妇经阴道分娩时应结合会阴条件,严格掌握侧切指征。

Objective To investigate the impact of episiotomy on the postpartum pelvic floor function in primary pregnancy. Methods756 cases of primary maternal vaginal delivery with episiotomy were collected for the study group. In addition,756 cases of cesarean section were selected as control group. Postpartum stress urinary incontinence,pelvic organ prolapse and pelvic floor muscle strength were screened and results were compared in two groups 42 days after delivery. Results In the study group,postpartum stress urinary incontinence（ 9. 13%） was significantly increased,which was significantly higher than control group（ 3. 31%）. In the study group,incidence of stage II pelvic organ prolapse（ 19.31%） was significantly higher（ 7. 41%） and incidence of perineal pain（ 6. 48%） was significantly higher than control group（ 1. 59%）. In the study group,Class I abnormal muscle fibers and Class I abnormal muscle fatigue muscle fibers（ 20. 89%,92. 72%） were significantly higher（ 13. 50%,75. 67%） and abnormal vaginal dynamic pressure（ 75. 79%） were also significantly higher than control group（ 49. 47%）,with significant difference（ P 〈 0. 05）. Conclusion The episiotomy can lead to pelvic floor dysfunction in patients and in primary maternal vaginal delivery. We should pay attention to perinea condition and strictly control lateral indications.