探究阴道分娩与剖宫产对产后盆底功能及产后性功能的影响

Impact of vaginal delivery and cesarean delivery on postpartum pelvic floor function and postpartum sexual function

目的:探究与分析不同生产方式对产后盆底功能及产后性功能的影响。方法:选取在2013年6月至2014年6月来我院进行分娩的70例产妇作为研究对象,按照生产方式的不同分为A、B两组,A组采取阴道分娩方式,B组采取剖宫产分娩方式,每组各35例。分别对两组产前和产后6周、12周及24周盆底肌力评分、膀胱颈角度及膀胱颈旋转角度异常率、中国女性性功能调查(FSFI)问卷评分进行对比分析。结果:A组产后6周、12周盆底肌力评分与产前相比均明显降低(P<0.05);A组产后24周盆底肌力评分与产前相比无明显差异(P>0.05);A组产妇产后6周、12周盆底肌力评分0至1分和2分的比例明显多于B组(P<0.05)。A组产后6周、12周膀胱颈角度及膀胱颈旋转角度异常率与产前相比均明显增加(P<0.05);A组产后24周膀胱颈角度及膀胱颈旋转角度异常率与产前相比无明显差异(P>0.05);A组产后6周及12周膀胱颈角度及膀胱颈旋转角度异常率明显高于B组(P<0.05)。A组产后6周、12周FSFI问卷5项指标评分与产前相比均明显降低(P<0.05);A组产后24周FSFI问卷5项指标评分与产前相比无明显差异(P>0.05);A组产妇产后6周及12周FSFI问卷5项指标评分显著低于B组(P<0.05)。结论:剖宫产对产后盆底功能及产后性功能的早期影响小于阴道分娩方式,但随着时间的推移两种生产方式的产妇产后的性功能均可恢复正常,不存在差异性。

Objectives： To probe into and analyze the impact of different delivery methods on postpartum pelvic floor function and sexual function. Methods： 70 puerpera in our hospital from June 2013 to June 2014 were selected as research objects,and according to the different methods of delivery,was divided into group A（ vaginal delivery） and group B（ cesarean delivery）,each of 35 cases. The pelvic floor muscle strength grade,the bladder neck Angle and abnormal rate of bladder neck rotation Angle,Chinese female sexual investigation questionnaire（ FSFI） score of the two groups before and 6 weeks,12 weeks and 24 weeks after the delivery were compared and analyzed. Results： The pelvic floor muscle strength score 6 weeks and 12 weeks after delivery was significantly lower than that before delivery in group A（ P〈0. 05）,while the difference between 24 weeks after delivery and that before delivery was not significant（ P〉0. 05）. The proportion of puerperal whose postpartum pelvic floor muscle score 6 weeks and 12 weeks after was between 0 to 1 and 2 points was significantly higher than that in group B（ P〈0. 05）. The abnormal rate of bladder neck angle and bladder neck rotation angle 6 weeks and 12 weeks after the delivery in group A significantly increased compared to that before delivery（ P〈0. 05）,while the difference between24 weeks after delivery and that before delivery was not significant（ P〉0. 05）. The abnormal rate of bladder neck angle and bladder neck rotation angle 6 weeks and 12 weeks after the delivery in group A was significantly higher than that in group B（ P〈0. 05）. The 5 indicators score of FSFI questionnaire 6 weeks and 12 weeks after the delivery was significantly lower than that before delivery in group A（ P〈0. 05）,while the difference between 24 weeks after delivery and that before delivery was not significant（ P〉0. 05）. The 5 indicators score of FSFI questionnaire 6 weeks and 12 weeks after the delivery in group A was significantly lower than that of group B（ P〈0. 05）. Conclusion： Impact of cesarean delivery on postpartum pelvic floor function and postpartum sexual function was less than vaginal delivery,but the difference disappears as the sexual function returns to normal with time going on.