自然裂伤与分娩中会阴侧切对初产妇盆底功能的影响

Influence of lateral perineal incision and natural laceration on pelvic floor function of primipara

目的:探讨自然裂伤与分娩中会阴侧切对初产妇盆底功能的影响。方法:选取2015年8月至2016年1月于我院经阴道分娩的初产妇131例进行研究,并分为研究组(会阴侧切)和对照组(自然裂伤),分娩42d后比较两组产妇第二产程、产后相关并发症、肌电位及盆底肌力。结果:排尿困难与压力排尿失禁组间比较差异无统计学意义(P>0.05)。研究组性生活障碍与会阴伤口疼痛发生率高于对照组,差异有统计学意义(P<0.05)。研究组第二产程(1.05±0.53)h,对照组第二产程(1.03±0.64)h,第二产程组间比较差异无统计学意义(t=0.191,P>0.05)。研究组肌电位(2.81±2.65)μV,对照组肌电位(2.89±2.79)μV,肌电位组间比较差异无统计学意义(t=0.162,P>0.05)。两组产妇产后42d盆底肌力比较差异无统计学意义(U_c=1.083<U,P>0.05)。结论:会阴侧切对初产妇盆底功能损伤较大,易发生性功能障碍与会阴伤口疼痛,选择该术式时应严格把握指征。

Objectives： To investigate the influence of lateral perineal incision and natural laceration on pelvic floor function of primipara. Methods： 131 primiparae adopting vaginal delivery in our hospital from August 2015 to January 2016 were chosen and divided into research group （ lateral perineal incision） and control group （natural laceration）. The second stage of labor, postpartum complications, myoelectric potential and pelvic floor muscle between the two groups were compared 42 days after delivery. Results ： Difference in the occurrence of dys- uresia and urinany incontinence between the two groups was not significant （P 〉 0. 05 ）. Incidence of sexual dysfunction and perineal wound pain of research group were all higher than those of control group, with statistically sig- nificant difference （ P 〈 0. 05 ）. The second stage of labor in research group and control group was （ 1.05 ± 0. 53 ） h and （ 1.03 ± 0. 64） h respectively, without statistically significant difference （ t = 0. 191, P 〉 0. 05 ）. The muscle potential in research group and control group was （2.81 ±2.65） μV and （2.89 ±2.79）μV respectively, without significant difference between the two groups （t =0. 162, P 〉0. 05）. Difference in the pelvic floor muscle 42 days after delivery between the two group was not significant （ Uc = 1. 083 〈 U, P 〉 0. 05 ）. Conclusion ： Lateral perineal incision has major damage to the pelvic floor function of primipara, including sexual dysfunction and perineal wound pain. Therefore, the operation should be chosen carefully with according indications.