不同分娩方式对女性产后女性压力性尿失禁发生风险及盆底肌表面电信号值的影响

Effects of Different Delivery Methods on the Risk of Postpartum Female Stress Urinary Incontinence and the Electrical Signal Value of Pelvic Floor Muscle Surface

【目的】探讨不同分娩方式对女性产后压力性尿失禁(SUI)发生风险及盆底肌表面电信号值的影响。【方法】选取2019年6月至2020年6月在延安大学附属医院产科进行产后42 d门诊复查的初产妇115例,根据分娩方式分为阴道分娩组(n=63)与剖宫产组(n=52)。比较两组产妇临床资料及产后42 d SUI发生率、盆底肌表面电信号值、膀胱颈活动度、尿道旋转角度。【结果】两组产妇年龄、孕次、产次、孕期增加体重、新生儿性别、新生儿出生体重比较,差异均无统计学意义(P>0.05)。阴道分娩组产后女性SUI发生率为26.98%(17/63),显著高于剖宫产组的11.54%(6/52),其差异有统计学意义(χ^(2)=4.248,P=0.039)。阴道分娩组快肌最大值、10 s慢肌、60 s慢肌、后静息值均小于剖宫产组(P<0.05),前静息值、快肌收缩时间大于剖宫产组(P<0.05),但快肌放松时间与剖宫产组比较差异无统计学意义(P>0.05)。阴道分娩组膀胱颈活动度、尿道旋转角度均大于剖宫产组(P<0.05)。【结论】与剖宫产相比,阴道分娩产后女性SUI发生风险较高,影响盆底肌表面电信号,明显增加膀胱颈活动度、尿道旋转角度,但剖宫产也无法完全避免产后女性SUI的发生,不建议为预防产后SUI发生而进行无医学指征的剖宫产。

【Objective】To investigate the effects of different delivery methods on the risk of postpartum female stress urinary incontinence(SUI)and the surface electrical signal value of pelvic floor muscle.【Methods】A total of 115 primiparas who underwent 42 days postpartum outpatient review in the obstetrics department of the Affiliated Hospital of Yan'an University from June 2019 to June 2020 were selected.They were divided into vaginal delivery group(n=63)and cesarean section group(n=52)according to the mode of delivery.The clinical data,the incidence of SUI,the electrical signal value of pelvic floor muscle surface,the activity of bladder neck and the angle of urethral rotation were compared between the two groups.【Results】There was no significant difference in maternal age,number of pregnancies,number of births,weight gain during pregnancy,neonatal gender and neonatal birth weight between the two groups(P>0.05).The incidence of SUI in postpartum women in the vaginal delivery group was 26.98%(17/63),which was significantly higher than 11.54%(6/52)in the cesarean section group(χ^(2)=4.248,P=0.039).The maximum value of fast muscle,10s slow muscle,60s slow muscle and post resting value in the vaginal delivery group were lower than those in the cesarean section group(P<0.05),and the pre-resting value and fast muscle contraction time were higher than those in the cesarean section group(P<0.05),but there was no significant difference in fast muscle relaxation time between the vaginal delivery group and the cesarean section group(P>0.05).The bladder neck mobility and urethral rotation angle in the vaginal delivery group were higher than those in the cesarean section group(P<0.05).【Conclusion】Compared with cesarean section,the risk of SUI in women after vaginal delivery is higher,which affects the electrical signal on the surface of pelvic floor muscle and significantly increases the activity of bladder neck and urethral rotation angle.However,cesarean section can not completely avoid the occurrence of SUI in postpartum women.Cesarean section without medical indications is not recommended to prevent the occurrence of postpartum SUI.