产妇盆底功能的相关影响因素及超声阴道电针治疗作用分析

Influencing factors on pelvic floor function and the effects of ultrasonic vaginal electroacupuncture on recovery of pelvic floor muscle function in parturients with pelvic floor functional disturbance

目的研究产妇盆底功能的相关影响因素及超声阴道电针治疗的作用。方法238例产妇根据分娩方式的不同将其分为阴道分娩组和剖宫产组,每组119例。通过问卷调查、查看病史资料、盆底肌检测等方式分析产妇发生盆底功能障碍性疾病(PFD)的情况及相关影响因素;调查所有患者经超声阴道电针治疗后盆底肌功能恢复情况。结果2组产妇在Ⅰ、Ⅱ类肌纤维异常发生率上差异无统计学意义(P>0.05);2组产妇妊娠期压力性尿失禁(SUI)发生率差异无统计学意义(P>0.05),产后6~10周SUI发生率阴道分娩组明显更高,差异有统计学意义(P<0.05);2组阴道前壁脱垂、阴道后壁脱垂发生率比较差异有统计学意义(P<0.05);导致产后PDF的相关危险因素包括年龄、阴道分娩、分娩前BMI、妊娠期增加体重指数(BMI)、第二产程时间以及新生儿体重(P<0.05);接受电针治疗后相较于治疗前盆底肌力和肌电压明显提升,差异有统计学意义(P<0.05)。结论年龄、阴道分娩、分娩前BMI、妊娠期增加BMI、第二产程时间以及新生儿体重是造成产妇PDF的主要危险因素,通过超声阴道电针治疗能够有效改善盆底肌力,促进盆底肌功能恢复,应用价值较高。

Objective To investigate the influencing factors on pelvic floor function and the effects of ultrasonic vaginal electroacupuncture on recovery of pelvic floor muscle function in parturients with pelvic floor functional disturbance(PFD).Methods A total of 238 parturients were divided into vaginal delivery group(n=119)and selective cesarean section group(n=119)according to different delivery modes.The questionnaire,disease history data and detection of pelvic floor muscle were performed to analyze the status of PFD and related influencing factors.The recovery of the pelvic floor muscle function after ultrasonic vaginal electroacupuncture was investigated in all the patients.Results There were no significant differences in the incidence rates of typeⅠ,typeⅡmuscle fiber abnormalities and gestational stress incontinence(SUI)between the two groups(P>0.05).The incidence rate of SUI at 6~10 weeks after delivery in vaginal delivery group was significantly higher than that in selective cesarean section group(P<0.05).There were significant differences in the incidence rates of prolapse of vaginal anterior wall and posterior vaginal between the two groups(P<0.05).Moreover,the related risk factors for postpartum PDF included patient’s age,vaginal delivery,prenatal delivery BMI,increased body mass index(BMI)during pregnancy,the second stage of labor and neonatal weight(P<0.05).The pelvic floor muscle strength and muscle pressure after treatment were significantly improved(P<0.05).Conclusion The patient’s age,vaginal delivery,prenatal delivery BMI,increased body mass index(BMI)during pregnancy,second stage of labor and neonatal weight are main risk factors inducing PDF in parturients.The ultrasound vaginal electroacupuncture can effectively improve the pelvic floor muscle strength and promote the recovery of the function of pelvic floor muscle,with higher application value.