不同分娩方式产妇盆底肌电分布及相关因素分析

Analysis of pelvic ? oor surface electromyography and relative factors in postpartum of different delivery ways

目的探讨不同分娩方式的产妇盆底肌电分布情况及其可能的影响因素,为促进产妇康复提供相关临床依据。方法选取在北京医院住院分娩后,于2018年1月1日至6月30日在盆底专科门诊复查的产妇389例。采用Glazer盆底肌电评估方案采集盆底肌电值,比较不同分娩方式、阴道分娩初产妇是否会阴侧切以及二孩产妇的肌电特征,分析不同因素对其影响。结果初产妇阴道分娩组的前静息平均值为(4.80±2.83)μV,后静息平均值为(3.64±2.01)μV,快速收缩最大值为(32.90±14.55)μV,持续收缩平均值为(22.29±11.60)μV,均明显低于剖宫产组和试产失败剖宫产组(P<0.05),试产失败剖宫产组的产妇前静息平均值和后静息平均值分别为(9.76±3.93)μV和(7.34±3.28)μV,均高于其他两组(P<0.05)。而初产妇是否行会阴侧切对盆底肌电的影响不大(P>0.05)。除二孩产妇的后静息变异性比初产妇更稳定(P<0.05)外,两组其他各项盆底肌电的比较差异无显著性(P>0.05)。结论试产失败剖宫产组的产妇盆底肌张力高、易疲劳,是重点康复人群。阴道分娩产妇的盆底肌功能不良,需要早期锻炼康复。

Objective:To describe the distribution of pelvic floor electromyography(EMG)in parturients with different delivery modes,and to explore the influencing factors,so as to provide relevant clinical evidence for promoting the recovery of parturients based on the findings.Method The delivery women were reexamined in pelvic floor clinic,from January 1 to June 30,2018.Finally 389 parturients met the selection criteria,who were delivery in our hospital.Pelvic floor surface EMG under resting state and different contraction states was acquired with Glaze revaluation scheme and compared with different groups.Result The mean values of pre-rest(4.80±2.83)μV,the mean values of post-rest(3.64±2.01)μV,the maximum of fast muscle(32.90±14.55)μV,the mean value of slow muscle(22.29±11.60)μV of primipara in vaginal delivery group were significantly lower than those in cesarean section group and the failure trial vaginal group(P<0.05).The mean values of pre-rest(9.76±3.93)μV,the mean values of post-rest(7.34±3.28)μV of the failure trial vaginal group was higher than that of the other two groups(P<0.05).The perineum lateral incision of primipara had little effect on the pelvic floor muscle(P>0.05).Conclusion The pelvic floor muscle were high tonus and fatigue in the failure trial vaginal group,which are the key rehabilitation groups.Vaginal delivery of the pelvic floor muscle function were poor,need early exercise rehabilitation.