第二产程时长对阴道分娩初产妇产后盆底肌力的影响

Effect of duration of the second stage of labor on postpartum pelvic floor muscle strength of primiparas after vaginal delivery

目的分析第二产程时长对阴道分娩初产妇产后盆底肌力的影响。方法选取268例初产妇,依据产妇第二产程时长将其分为[A组(77例,时长<2 h)、B组(85例,2 h≤时长<3 h)及C组(106例,时长≥3 h)]。三组产妇均行盆底肌训练,观察盆底肌力差异。结果C组排尿困难发生率46.23%、尿失禁发生率45.28%高于A组15.58%、10.39%及B组10.59%、24.71%,比较差异具有统计学意义(P<0.05)。C组性生活障碍发生率44.34%、伤口疼痛发生率30.19%高于A组6.49%、15.58%及B组9.41%、5.88%,比较差异具有统计学意义(P<0.05)。C组Ⅰ类肌纤维肌力损伤率78.30%高于A组48.05%、B组64.71%,比较差异具有统计学意义(P<0.05)。C组Ⅰ类肌力阴道压力(72.46±7.43)cmH_(2)O,H类肌纤维肌力阴道压力(81.39±9.57)cmH_(2)O低于A组(76.56±8.64)cmH_(2)O,(84.87±8.86)cmH_(2)O以及B组(75.39+8.02)cmH_(2)O,(86.37±8.26)cmH_(2)O,比较差异具有统计学意义(P<0.05)。C组I类肌纤维疲劳度情况(8.04±0.83)%、Ⅱ类肌纤维疲劳度情况(3.16±0.67)%高于A组(7.65±0.67)%、(2.95±0.54)%以及B组(7.71±0.72)%,(2.84±0.43)%,比较差异具有统计学意义(P<0.05)。C组子宫脱垂发生率27.36%高于A组14.29%、B组5.88%,比较差异具有统计学意义(P<0.05)。结论第二产程时长可对阴道分娩初产妇产后盆底肌力产生一定的影响。

Objective To analyze the influence of the duration of the second stage of labor on the pelvic floor muscle strength of primipara after vaginal delivery.Methods 268 primiparas were selected and divided into group a(77 cases,duration<2h),group b(85 cases,duration<2h)and group c(106 cases,duration≥3h)according to the duration of the second labor.All parturients in 3 groups underwent pelvic floor muscle training,and the difference of pelvic floor muscle strength was observed.Results The incidence of dysuria and 45.28%of urinary incontinence in group C were higher than those in group A,15.58%,10.39%,and 10.59%,24.71%in group B,and the differences were statistically significant(P<0.05).The incidence of sexual life disorder in group C was 44.34%,and the incidence of wound pain was 30.19%,which was higher than that in group A,6.49%,15.58%,and 9.41%,5.88%in group B,and the differences were statistically significant(P<0.05).The muscle strength injury rate of class Ⅰ muscle fibers in group C was 78.30%higher than that in group A,48.05%,and 64.71%in group B,and the difference was statistically significant(P<0.05).The vaginal pressure of class Ⅰ muscle force(72.46±7.43)cmH_(2)O and the vaginal pressure of class Ⅱ muscle fiber muscle force(81.39±9.57)cmH_(2)O in group C were lower than those in group A(76.56±8.64)cmH_(2)O,(84.87±8.86)cmH_(2)O and group B(75.39±8.02)cmH_(2)O,(86.37±8.26)cmH_(2)O,the difference was statistically significant(PV0.05).The degree of fatigue of muscle fibers in group C(8.04±0.83)%and type Ⅱ muscle fibers(3.16±0.67)%were higher than those in group A(7.65±0.67)%,(2.95±0.54)%and group B(7.71±0.72)%,(2.84±0.43)%,the difference was statistically significant(P<0.05).The incidence of uterine prolapse in group C was 27.36%higher than that in group A,14.29%,and 5.88%in group B,and the difference was statistically significant(P<0.05).Conclusion The duration of the second stage of labor can affect the pelvic floor muscle strength of primiparas after vaginal delivery.