导乐镇痛对初产妇产后早期盆底功能的影响

The effects of Doula delivery analgesia on early postpartum pelvic floor function in primiparas

目的探讨导乐分娩镇痛对足月初产妇产后早期盆底功能的影响。方法选择2018年7月1日至9月22日在武汉市某三甲医院自然分娩的足月初产妇为研究对象,其中应用导乐分娩镇痛的40名孕妇为实验组,常规分娩的40名孕妇为对照组。产前收集产妇妊娠期资料、盆底功能资料,产后2小时内收集产妇的分娩资料、视觉模拟评分(VAS)。产后42天对产妇进行盆底表面肌电图检测。结果实验组VAS疼痛评分明显低于对照组、第一产程时间少于对照组,差异均有统计学意义(t值分别为10.49、3.97,均P<0.05),两组第二产程时间、阴道裂伤程度、外阴侧切率比较差异均无统计学意义(均P>0.05);实验组Ⅰ类肌纤维肌力明显高于对照组,差异有统计学意义(t=2.06,P<0.05),两组Ⅰ类肌纤维疲劳度、Ⅱ类肌纤维肌力、Ⅱ类肌纤维疲劳度比较差异均无统计学意义(均P>0.05)。结论导乐分娩镇痛能缓解疼痛,缩短第一产程时间,改善盆底肌力,有利于提高产妇产后盆底功能。

Objective To explore the effect of Doula delivery analgesia on early postpartum pelvic floor function of primiparas.Methods From July 1,2018 to September 22,2018,the full-term primiparas delivered naturally in a tertiary hospital in Wuhan city were selected as the study subjects.Among them,40 pregnant women who used Doula delivery analgesia were the experimental group,40 pregnant women who delivered regularly were the control group.Maternal data and pelvic floor function information during pregnancy were collected before delivery.And maternal delivery data and visual analog score(VAS) were collected within 2 hours after delivery.Pelvic floor surface electromyography was performed on the postpartum women at 42 days.Results The VAS and the first stage of labor time in the experimental group were significantly lower than those in the control group(t=10.49 and 3.97,respectively,both P<0.05).But no significant difference was found in the second stage of labor time,vaginal laceration degree and vulvar lateral incision rate between the two groups(all P>0.05).Strength of type Ⅰ muscle fiber in the experimental group was significantly higher than that in the control group(t=2.06,P<0.05).But no significant difference was found in strength of type Ⅱ muscle fiber,degree of fatigue of type Ⅰ muscle fiber and type Ⅱ muscle fiber between the two groups(all P>0.05).Conclusion Doula delivery analgesia can relieve pain,shorten the first stage of labor and improve the strength of pelvic floor muscle,which is conducive to improving postpartum pelvic floor function.