418例产妇产后早期盆底肌力损伤的相关因素分析

418 cases of postpartum pelvic floor muscle injury related factors for early analysis

目的探讨不同因素对产后早期盆底肌力损伤的影响,为产后盆底功能障碍性疾病（pelvic floor dysfunction,PFD）的早期防治提供临床依据。方法采用统一的检测方法和诊断标准,对2015年4月~11月本院收治的产后42~60天内的418例产妇进行盆底功能检查,分析不同因素对产后盆底肌力的影响。结果所有产妇中盆底肌力异常（≤3级）发生率为59.6%（249例）。多因素分析可知,与剖宫产相比,阴道分娩及产钳均显著增加产妇产后盆底肌力受损的风险;与孕期体重增加〈10kg的产妇相比,体重增加≥20kg的产妇产后盆底肌损伤的风险显著升高;与新生儿体重〈3000g的产妇相比,新生儿体重≥3500g时,产后盆底肌力损伤的风险显著增加;与孕周〈37周相比,孕周≥41周的产妇产后盆底肌力损伤的风险显著升高,以上差异均具有显著性（P〈0.05）。结论产后早期盆底肌力损伤发生率高,盆底肌损伤与分娩方式、分娩孕周、孕期体重和新生儿体重等多种因素有关。应加强围产期盆底知识宣教和管理,做到早期防治,以减少远期PFD的发生。

Objective To investigate the risk factors for postpartum pelvic floor muscle injury at 6 weeks after delivery.Method From April 2015 to December 2015, 418 women were accepted postpartum pelvic floor function screening after delivery in Beijing Hospital. Pelvic examination and pelvic floor muscle strength testing were carried out in these women.All the data were analyzed with multivariate logistic regression method to explore the related factors for postpartum pelvic floor muscle injury.Result The incidence of muscle strength grades less than third grade was 59.6%（249 cases）.Results from logistic regression analysis showed that factors as delivery, weight again during pregnancy more than 20 kg and gestational age more than 41 weeks were risk factors for postpartum pelvic floor muscle injury.Conclusion The incidence of postpartum pelvic floor muscle injury was high. Since postpartum pelvic floor muscle injury could be caused by various factors, perinatal intervention and maternal education should be targeting on risk factors in multi-dimensional way.