阴道分娩与剖宫产分娩对初产妇早期盆底功能障碍的影响分析

Effect of Vaginal Delivery and Cesarean Section on Early Pelvic Floor Dysfunction in Primiparas

目的分析阴道分娩与剖宫产分娩对初产妇早期盆底功能障碍的影响。方法通过对我院2013年10月-2015年5月妇产科就诊收治的100例初产妇资料做回顾性分析,根据分娩方式的不同,分为阴道顺产组和剖宫产组,各50例。比较并分析两组产妇的早期盆底功能障碍情况,包括肌力受损率、压力性尿失禁(SUI)发生率及盆腔器官脱垂(POP)的发生率。结果两组产妇盆底深层肌力受损率及盆底浅层肌力受损率比较,差异均无统计学意义(P>0.05),阴道顺产组阴道前壁脱垂率、阴道后壁脱垂率、子宫脱垂率均明显高于剖宫产组(P<0.05),两组产妇在孕期、产后1个月、产后6个月SUI发生率的比较无明显差异(P>0.05)。结论阴道顺产和剖宫产在产妇盆底肌力受损率及SUI发生率比较无明显差异,但是选择性剖宫产可降低POP发生的危险性,有利于产妇早期功能康复及提高生存质量。

Objective To analyze the effect of vaginal delivery and cesarean section on early pelvic floor dysfunction in primiparas. Methods One hundred cases of primiparas admitted to our hospital between October 2013 and May 2015 were ana- lyzed retrospectively. They were divided into the vaginal delivery group and cesarean section group （50 cases in each） according to the different modes of delivery. The early pelvic floor dysfunction,including SUI incidence, POP incidence and muscle strength, was compared between the two groups. Results No significant difference was detected in the damage rate of the strength of the deep muscle of the pelvic floor （P〉0. 05 ） or in that of the strength of the superficial muscle （P〉0. 05 ） between the two groups. The rates of vaginal anterior wall prolapse, vaginal posterior wall prolapse, and uterine prolapse were significantly higher in the va- ginal delivery group than those in the cesarean section group （P〈0. 05 ）. No significant difference was detected in the incidence of SUI between the two groups during pregnancy,postpartum one month or postpartum six months （P〉0. 05 ）. Condusiou No signifi- cant difference is detected between vaginal cesarean and cesarean section in the damage rate of maternal pelvic floor muscle or in the incidence of SUI. However, selective cesarean section can reduce the risk of POP, which is conducive to early functional rehabilita- tion of mothers and to the quality of life.