剖宫产与顺产对孕妇产后性功能、盆底结构功能、生活质量和相关激素的影响

Effects of cesarean section and spontaneous delivery on sexual function, pelvic floor structureand function, quality of life and related hormones in pregnant women

目的对比分析剖宫产与顺产对孕妇产后性功能、盆底结构功能、生活质量和相关激素的影响。方法选取2015年1月至2017年1月在西安高新医院进行分娩的健康孕妇750例作为研究对象。按照其分娩方式的不同将其分为剖宫产组(n=350)与顺产组(n=400)。于产后6个月,采用盆底肌力评分、健康状态调查问卷、女性性功能量表对比两组孕妇的盆底结构功能生活质量以及性功能,并检测孕激素、雌二醇、黄体生成素以及卵泡刺激素等性功能相关激素的水平。结果两组孕妇产后6个月的盆底结构功能相比差异无统计学意义(P>0.05);顺产组的躯体功能、情绪功能、角色功能和社会功能评分均明显高于剖宫产组(P<0.05),差异具有统计学意义;两组孕妇产后6个月的孕激素、雌二醇、黄体生成素以及卵泡刺激素等性功能相关激素的水平相比,其差异均无统计学意义(均P>0.05);两组孕妇产后6个月的性唤起、性欲、阴道润滑程度、性生活满意度、性高潮以及性交疼痛相比,其差异均无统计学意义(均P>0.05)。结论剖宫产与顺产孕妇产后6个月的盆底结构功能、性功能及性功能相关激素无明显差异,但顺产孕妇产后6个月的生活质量优于剖宫产。

Objective To investigate the effects of cesarean section and spontaneous delivery on sexual function,pelvic floor structure and function,quality of life and related hormones in pregnant women.Methods 750 healthy pregnant women who were delivered in our hospital from January 2015 toJanuary2017were selected and divided into cesarean section group and spontaneous delivery group.At 6 months postpartum,the pelvic floor muscle strength score,health status questionnaire,female sexual function index was compared between the two groups to compare the pelvic floor structure and function,quality of life and sexual function.The level of progesterone,estradiol,luteinizing hormone and follicle stimulating hormone of sexual function such as hormone were detected.Results There was no significant difference in pelvic floor structure and function between the two groups after 6 months postpartum(P>0.05).The scores of physical function,emotional function,role function and social function in the spontaneous delivery group were significantly higher than those in the cesarean section group(P<0.05).There were no significant differences in the levels of sex related hormones such as progesterone,estradiol,luteinizing hormone and follicle stimulating hormone between the two groups at 6 months after birth(P>0.05).There was no significant difference in sexual arousal,sexual desire,vaginal lubrication,sexual life satisfaction,orgasm,and sexual pain between the two groups at 6 months postpartum(all P>0.05).Conclusions There is no significant difference in pelvic floor structure and function,sexual function and sexual function related hormone betweenpuerpera aftercesarean section and spontaneous delivery at 6 months postpartum,but the quality of life is better in puerperaadopting spontaneous delivery at 6 months postpartum.