选择性剖宫产和阴道分娩方式对产妇盆底功能障碍的影响

Effect of elective caesarean section and vaginal delivery on maternal pelvic floor dysfunction

目的：探讨选择性剖宫产和阴道分娩方式对产妇盆底功能障碍的影响。方法随机选取2014年1月至2015年3月我院生产的131例孕妇作为本次研究对象，根据分娩方式不同将孕妇分成选择性剖宫产组（观察组）和阴道分娩组（对照组），统计所有产妇及新生儿临床资料，观察不同分娩方式产妇产后6～8周盆底功能障碍疾病的发生情况，统计并分析比较发生阴道前后壁脱垂、子宫脱垂、压力性尿失禁（SUI）产妇数以及产妇盆底肌力受损情况。结果观察组有31例产妇出现不同程度阴道前壁脱垂现象，脱垂率为67．39％；对照组阴道前壁脱垂产妇较多，脱垂率为92．94％，差异有统计学意义（P ＜0．05）。观察组产妇阴道后壁脱垂13例，脱垂率只有28．26％，对照组阴道后壁脱垂产妇较多，约占75．29％，差异有统计学意义（P ＜0．05）。观察组产妇子宫脱垂率约为13．04％，对照组子宫脱垂产妇共30例，脱垂率为35．29％，差异有统计学意义（P ＜0．05）。观察组有6例产妇发生SUI，概率约为13．04％，对照组发生 SUI 的概率为29．41％，差异有统计学意义（P ＜0．05）；2组产妇盆底深层和浅层肌力损伤率相差不大，差异无统计学意义（P ＞0．05）。结论选择性剖宫产的产妇产后发生盆底功能障碍疾病概率小于阴道分娩的产妇，有利于产妇自身恢复，但是产妇盆底肌力损伤与分娩方式无关。

Objective To explore the impact of elective caesarean section and vaginal delivery on maternal pelvic floor dysfunction. Methods A total of 131 pregnant women from January 2014 to March 2015 in our hospital were divided into observation group which re-ceived elective caesarean section and control group which received vaginal delivery.All the maternal and neonatal clinical data were counted. The occurrence of pelvic floor dysfunction disease in postpartum women after 6 to 8 weeks was observed.The occurrence of vaginal wall pro-lapse,uterine prolapse,stress urinary incontinence （SUI）and maternal pelvic floor muscle damage between two groups were compared and analyzed.Results There were varying degrees anterior vaginal wall prolapse phenomenon occured on 31 cases in obervation group,the pro-lapse rate was 67.39%,compared with 92.94% of the control group,the difference was statistically significant （P 〈0.05）.Observation group with 13 cases of descent vaginae posterior,the prolapse rate was only 28.26%,compared with 75.29% of the control group,the differ-ence was statistically significant （P 〈0.05 ）.The maternal uterine prolapse rate of observation group was about 13.04%,compared with 35.29%（30 cases）of the control group,the difference was statistically significant （P 〈0.05）.Observation group with 6 cases of maternal SUI, the probability is about 13.04%,compared with 29.41% of control group,the difference was statistically significant （P 〈0.05）.There was no significant difference in deep and shallow maternal pelvic floor muscle between two groups（P 〉0.05）.Conclusion To adopt elective cesar-ean section has a lower probabilities of postpartum pelvic floor dysfunction disease than that by vaginal delivery for maternal women,which is propitious to the recovery of pregnant women,while it has nothing to do with pelvic floor muscle damage.