分娩方式差异对产后盆底肌力的影响

Influence of Different Delivery Modes on Early Pelvic Floor Dysfunction

目的研究不同分娩方式对产后早期盆底功能障碍的影响。方法选择2017年12月—2018年6月进行产后42 d门诊复查的271例产妇,随机抽取行阴道分娩的82例为对照组,行剖宫产的82例为观察组。两组研究对象复查时均进行常规妇科检查、盆腔器官脱垂定量分度法(POP-Q)评分,同时进行盆底肌力测量,并比较两组的压力性尿失禁、不同程度盆腔器官脱垂等盆底功能障碍疾病发生率以及盆底肌纤维肌力。结果观察组产后的压力性尿失禁、不同程度盆腔器官脱垂发生率明显低于对照组(P <0. 05);观察组的Ⅰ类肌纤维肌力0～3级、Ⅱ类肌纤维肌力0～3级所占比例均明显低于对照组(P <0. 05)。结论剖宫产可以降低产后早期POP及盆底肌力异常的发生率,安全性较高,但远期影响目前不能确定。

Ojbective To study the effect of different modes of delivery on pelvic floor dysfunction in early postpartum.Methods The subjects of the study were 271 cases of pregnant women who were examined in the outpatient department of our hospital in 42 days after delivery from December 2017 to June 2018.We randomly selected 82 cases of vaginal deliveries as the control group,and 82 cases of cesarean deliveries as the observation group.Routine gynecological examination and POP-Q scoring were conducted for the reexamination of the two groups.The pelvic floor muscle strength was also measured.The incidence rate of pelvic floor dysfunction diseases such as forced urinary incontinence and pelvic floor muscle fiber muscle strength were compared between the two groups.Results The incidence of postpartum stress urinary incontinence and degrees of pelvic organ prolapse in the observation group were significantly lower than the control group(P<0.05).The proportion of type I muscle fiber muscle strength 0~3 and type II muscle fiber strength 0~3 in the observation group was significantly lower than those in the control group(P<0.05).Conclusion Cesarean section can reduce the incidences of early postpartum POP and pelvic floor muscle dysplasia,with high safety and worthy of clinical promotion,but the long-term impact is uncertain at present.