不同分娩方式对于盆底功能影响及康复治疗

Effect of different delivery modes on pelvic floor function and rehabilitation

目的探讨不同分娩方式对于盆底功能的损伤及康复治疗效果。方法选取2012年3月~2014年6月在我院住院分娩的356例产妇作为研究对象,顺产160例,选择性剖宫产196例,均采用Glazer盆底表面肌电评估方案进行康复治疗,比较顺产组及剖宫产组产后的膀胱颈移动度、盆底功能障碍性疾病发生情况及盆底肌力评分、15s内收缩次数。结果剖宫产组膀胱颈角度及膀胱颈旋转度明显低于对照组,差异比较有统计学意义（P〈0.05）;剖宫产组产后阴道脱垂发生率为32.14%,明显低于顺产组为71.88%,差异比较有统计学意义（P〈0.05）;剖宫产组盆底肌力评分明显高于对照组,15s收缩次数多于对照组,差异比较有统计学意义（P〈0.05）。结论相比于剖宫产,顺产更易出现早期阴道脱垂,降低盆底肌力作用明显。

Objective To explore the effect of different delivery modes on pelvic floor functional injury and rehabilitation. Methods 356 parturient women who were hospitalizes in our hospital from March 2012 to June 2014 were selected as research objects. Among them,160 were with spontaneous delivery and 196 were with selective cesarean section.All of them were received Glazer pelvic floor surface EMG assessment scheme for rehabilitation.Bladder cervical mobility,pelvic floor dysfunction,pelvic floor muscle strength score and contraction times of pelvic floor muscle in 15 s of two groups were compared. Results Bladder cervical angle and bladder cervical rotation degree of the cesarean section group were significantly lower than those of spontaneous delivery group and the difference was statistically significant（P〈0.05）.Incidence of coleoptosis after delivery of the cesarean section group was 32.14% which was significantly lower than that of the spontaneous delivery group 71.88%.The difference had statistical significance（P〈0.05）.Pelvic floor muscle strength score of the cesarean section group was significantly higher than that of the spontaneous delivery group.In addition, contraction times of pelvic floor muscle in 15 s of the cesarean section group was more than that of the spontaneous delivery group. The difference had statistical significance（P〈0.05）. Conclusion Spontaneous delivery is more likely to show early coleoptosis and it decreases pelvic floor muscle strength obviously compared with cesarean section.