分娩方式对阴道静息压力、盆底肌肉力量和耐力的影响

Effects of delivery modes on vaginal resting pressure,pelvic floor muscle strength and endurance

目的探究不同分娩方式对阴道静息压力(VRP)、盆腔底肌肉(PFM)力量和耐力的影响,并研究该指标在尿失禁产妇和正常产妇中是否不同。方法选择该院自然分娩(顺产组)、剖宫产(剖宫产组)、助产(助产组)和未孕未产妇(未孕未产组)各200例,对产妇怀孕中期(21周)和分娩后6周后VRP、PFM力量和耐力进行检测,以评价VRP、PFM的变化。结果剖宫产组从怀孕中期到产后6周,VRP降低,差异有统计学意义(P<0.05),顺产组和助产组PFM力量和耐力都有降低,且差异有统计学意义(P<0.01),而未孕未产组差异无统计学意义(P>0.05);顺产组、助产组与剖宫产组的VRP和PFM比较,VRP均降低,分别是剖宫产组的2.7和3.0倍,PFM力量亦降低,是剖宫产组的4倍和5倍,PFM耐力分别是剖宫产组的4.3和5.4倍,差异有统计学意义(P<0.01),在顺产组和助产组的比较中,VRP和PFM指标无显著性变化,差异无统计学意义(P>0.05)。结论产妇经阴道分娩更容易降低阴道静息压力、盆底肌肉力量和耐力。

Objective To study the effect of different delivery modes on vaginal resting pressure（VRP）,pelvic floor muscle（PFM） strength and endurance, and to further explore the differences in these measurements between pregnant women with and without urinary incontinence. Methods Eight hundred women who underwent natural childbirth（vaginal delivery, group A）, cesarean section women（group B）, midwifery（group C） and also non-pregnant nulliparous women（group D） were chosen and each group included two hundred women. The change of VRP, PFM strength and endurance were tested at mid-pregnancy（21 gestational weeks） and 6th week after childbirth. Results In the groups A, B and C, VRP significantly decreased at 6th week after parturition compared with that at mid-pregnancy（P〈0.05）. In the groups A and C, PFM strength and endurance significantly reduced at 6th week after parturition compared with those at mid-pregnancy（P〈0.01）. There was no significant difference in the VRP or PFM in the group D（P〉0.05）. In the 6th week after parturition, VRP, PFM strength and PFM endurance significantly reduced in the groups A and C compared with those in the group B（P〈0.01）; while VRP and PFM showed no significant differences between the group A and the group C（P〉0.05）. Conclusions Nature childbirth can reduce vaginal resting pressure, pelvic floor muscle strength and endurance more than other delivery modes.