阴道分娩不同助产方式对盆底功能的影响

Effect of different delivering methods on pelvic floor function in vaginal delivery

目的采用经会阴三维超声探讨阴道分娩中不同助产方式对妇女盆底功能的影响。方法选取经阴道分娩的产妇84名,按助产方式的不同分为会阴完整组32例、会阴侧切组30例、产钳助产组22例。分别获得静息状态、瓦氏动作和缩肛动作时盆隔裂孔图像,比较3组妇女产后盆隔裂孔前后径和面积的差异。结果会阴完整组和会阴侧切组于静息状态、瓦氏动作和缩肛动作时盆隔裂孔的前后径、面积差异均无统计学意义(P均>0.05)。会阴完整组和产钳助产组在静息状态、瓦氏动作和缩肛动作时的盆隔裂孔前后径、面积,静息—瓦氏和静息—缩肛时盆隔裂孔改变面积差异均有统计学意义(P均<0.05)。结论产钳对盆底功能的损伤大于自然阴道分娩,阴道分娩中,是否会阴切开对盆底功能损伤无明显差异。

Objective To explore the effect of different delivering methods on the pelvic floor function in vaginal delivery by transvaginal three-dimensional ultrasound.Methods Eighty-four patients delivered transvaginal were classified into three groups according to the mode of delivery（perineal integrity group [n=32],episiotomy group [n=30]and forceps delivery group[n=22]）.The hiatal images at resting,Valsalva,levator ani muscle maximum contraction were obtained and compared in three groups.Results There were no differences between perineal integrity group and episiotomy group in hiatal diameter and area（P〉0.05）.There were significantly differences between perineal integrity group and forceps delivery group in hiatal diameter,area and change in hiatal area from rest to pelvic floor muscle contraction and from rest to Valsalva（all P〈0.05）.Conclusion The injury of the pelvic floor of forceps delivery group is bigger than perineal integrity.And episiotomy is no significant difference with pelvic floor function injury.