会阴侧切分娩助产对经阴道自然分娩产妇产后盆底功能的影响

Effect of lateral episiotomy on postpartum pelvic floor function of vaginal delivery

目的探讨会阴侧切分娩助产对经阴道自然分娩产妇产后盆底功能的影响。方法回顾性分析2019年2月至2021年2月大连市妇女儿童医疗中心(集团)春柳院区收治的行阴道自然分娩的86例足月产妇的临床资料,依据助产技术不同将其分为会阴侧切组和非侧切组,每组各43例。会阴侧切组患者在经阴道自然分娩中进行会阴侧切,非侧切组患者在经阴道自然分娩中未进行会阴侧切。比较两组患者的压力性尿失禁(SUI)、会阴疼痛程度、盆底肌肌电值、盆腔器官脱垂(POP)、POP分期及盆底肌力。结果会阴侧切组患者产后42 d的SUI发生率高于非侧切组,产后42 d的视觉模拟评分法(VAS)评分高于非侧切组,产后42 d的盆底肌肌电值低于非侧切组,差异有统计学意义(P<0.05);两组患者产后42 d的POP发生率、POP分期及盆底浅部Ⅰ类、Ⅱ类肌纤维肌力、深部Ⅰ类、Ⅱ类肌纤维肌力比较,差异无统计学意义(P>0.05)。结论在经阴道自然分娩产妇中采用会阴侧切分娩助产会增加SUI发生率及产后会阴疼痛,加重对盆底肌功能的损伤,故需要限制会阴侧切的使用,严格掌握会阴侧切指征。

Objective To explore the effect of lateral episiotomy on postpartum pelvic floor function of vaginal delivery.Methods The clinical data of 86 full-term pregnant women who underwent vaginal delivery in Chunliu District of Dalian Women and Children Medical Center(Group)from February 2019 to February 2021 were retrospectively analyzed.According to the midwifery technology,they were divided into lateral episiotomy group and non lateral episiotomy group,43 cases in each group.The patients in the lateral episiotomy group underwent lateral episiotomy during vaginal natural delivery,and the patients in the non lateral episiotomy group did not undergo lateral episiotomy during vaginal natural delivery.The stress urinary incontinence(SUI),perineal pain,pelvic floor muscle electromyography,pelvic organ prolapse(POP),POP stage and pelvic floor muscle strength were compared between the two groups.Results The incidence of SUI at 42 d after delivery in the lateral episiotomy group was higher than that in the non lateral episiotomy group,the visual analogue scale(VAS)score at 42 d after delivery was higher than that in the non lateral episiotomy group,and the pelvic floor muscle electromyography at 42 d after delivery was lower than that in the non lateral episiotomy group,the differences were statistically significant(P<0.05).There were no significant differences between the two groups in the incidence of POP,POP stage,shallow classⅠand classⅡmuscle fiber strength,deep classⅠand classⅡmuscle fiber strength at 42 d after delivery(P>0.05).Conclusion The use of lateral episiotomy in vaginal delivery can increase the incidence of SUI and perineal pain,and aggravate the damage to pelvic floor muscle function.Therefore,it is necessary to limit the use of lateral episiotomy and strictly grasp the indications of lateral episiotomy.