不同分娩方式对初产妇产后盆底功能的影响

Effect of Different Delivery Methods on Postpartum Pelvic Floor Function of Primipara

目的探讨不同分娩方式对初产妇产后盆底功能的影响。方法选取2018年5月至2019年4月于我院进行分娩的284例初产妇为研究对象,按照分娩方式的不同分成阴道分娩组(150例)与剖宫产组(134例),阴道分娩组初产妇采取经阴道分娩,剖宫产组初产妇采取剖宫产,产后均进行6个月的随访,对两组初产妇产后1、3、6个月盆底肌力受损情况、性生活质量评分以及产后6个月内盆底器官脱垂发生情况进行统计和比较。结果产后1个月,剖宫产组Ⅰ类肌纤维肌力与Ⅱ类肌纤维肌力的受损率显著低于阴道分娩组(P <0.05);产后3个月及6个月,两组产妇的Ⅰ类肌纤维肌力与Ⅱ类肌纤维肌力的受损率比较差异无统计学意义(P> 0.05)。产后1个月及3个月,剖宫产组性生活质量评分高于阴道分娩组(P <0.05);产后6个月,两组性生活质量评分评分比较无显著统计学差异(P> 0.05);产后6个月内,剖宫产组阴道前壁膨出、阴道后壁膨出、子宫脱垂发生率均显著低于阴道分娩组(P <0.05)。结论对于临床分娩的初产妇,采取经阴道分娩方式的盆底损伤较采取剖宫产分娩方式更严重,且容易发生盆底器官脱垂,所以需要进行早期有效的干预。

Objective To explore the effects of different delivery methods on the postpartum pelvic floor function of primiparas.Methods A total of 284 primiparas who gave birth in our hospital from May 2018 to April 2019 were selected as the research objects,and they were divided into vaginal delivery group(150 cases)and cesarean delivery group(134 cases)according to different delivery methods.The primiparas in the vaginal delivery group were given vaginal delivery,and the primiparas in the cesarean delivery group were given cesarean.All were followed up for 6 months after delivery.Statistics and comparison of pelvic fl oor muscle strength impairment,quality of sexual life scores and the occurrence of pelvic fl oor organ prolapse within 6 months of postpartum were made between the two groups of primiparas.Results At one month after delivery,the impaired rate of the muscle strength of typeⅠand typeⅡmuscle fi bers in the cesarean delivery group was signifi cantly lower than that in the vaginal delivery group(P<0.05).At three months and six months after delivery,there was no statistically signifi cant diff erence between the two groups of parturients in the impaired rate of typeⅠand typeⅡmuscle fi ber strength(P>0.05).At one month and three months after delivery,the quality of sexual life score of the cesarean delivery group was higher than that of the vaginal delivery group(P<0.05);at six months after delivery,there was no signifi cant diff erence in the scores of the quality of sexual life between the two groups(P>0.05).Within 6 months after delivery,the incidence of anterior vaginal wall bulging,posterior vaginal wall bulging,and uterine prolapse in the cesarean delivery group were signifi cantly lower than those in the vaginal delivery group(P<0.05).Conclusion For primiparas in clinical delivery,the pelvic fl oor injury caused by vaginal delivery is more serious than cesarean delivery,and pelvic fl oor organ prolapse is prone to occur,so early eff ective intervention is needed.