【目的】分析自然分娩产妇产后会阴部疼痛。【方法】选择自然生产的产妇120例,记录产妇产后的会阴部创伤情况,新生儿分娩时的胎方位及胎儿体重,采用视觉模拟评分法（VAS）对产后1 d 和产后4 d的会阴部疼痛情况进行评分。【结果】VAS 评...【目的】分析自然分娩产妇产后会阴部疼痛。【方法】选择自然生产的产妇120例,记录产妇产后的会阴部创伤情况,新生儿分娩时的胎方位及胎儿体重,采用视觉模拟评分法（VAS）对产后1 d 和产后4 d的会阴部疼痛情况进行评分。【结果】VAS 评分中,产妇产后1 d 的会阴部疼痛发生率较高,疼痛发生率为88.33%（106/120）,中重度疼痛发生率25.00%；产后4 d 会阴部疼痛发生率为25.00%（30/120）,中重度疼痛比例为1.67%；120例产妇中,16例产妇会阴部完好无损,53例产妇为Ⅰ、Ⅱ撕裂；51例产妇会阴部疼痛的危险因素分析：硬膜外分娩镇痛、自发撕裂、初产妇及会阴侧切的产妇更易出现会阴部疼痛。【结论】自然分娩产妇中会阴部疼痛情况较为常见,但是疼痛程度相对较轻,且产妇的会阴部疼痛与产妇的会阴侧切、硬膜外分娩镇痛等密切相关。展开更多
BACKGROUND The prevalence of perineal endometriosis(PEM)is low among women with endometriosis(EM)treated by surgery.It manifests as hard or cystic nodules with pain in the perineal wounds and surrounding areas.Implant...BACKGROUND The prevalence of perineal endometriosis(PEM)is low among women with endometriosis(EM)treated by surgery.It manifests as hard or cystic nodules with pain in the perineal wounds and surrounding areas.Implantation theory is regarded as the main pathogenesis of PEM.There are few clinical studies on the incidence and clinical characteristics of PEM.This study aims to summarize the clinical data of 14 PEM cases and analyze the factors that may be related to the incubation period and pain.AIM To analyze the medical history,clinical manifestations,diagnosis,treatment and treatment effect of PEM.METHODS The present study is a case series.We collected the clinical data and follow-up data of 14 patients with PEM who visited The International Peace Maternal and Child Health Hospital Affiliated to Shanghai Jiaotong University from January 2009 to December 2019.Paired t test and Pearson correlation analysis were used for statistical analysis.P<0.05 was considered statistically significant.RESULTS The 14 patients included had a history of vaginal delivery.All patients underwent PEM lesion resection.Three patients were treated by levator ani muscle repair at the same time and 1 patient underwent extensive PEM lesion resection and anal sphincter repair.Body mass index(BMI)at delivery and BMI within 1 mo after delivery were negatively correlated with the latent period,respectively(R2=0.53/0.86,P<0.05).The average visual analog scale score in lesions at the third month after surgery was 0.57±1.28 for all patients,which was significantly lower than that prior to surgery(P<0.05).One patient relapsed during the sixth month after surgery,and to date,no recurrence occurred after the second surgery.CONCLUSION The higher the BMI during delivery and within 1 mo after delivery,the shorter the incubation period of PEM.It is very important to evaluate the location of lesions before surgery.Surgical resection of the lesion is the best treatment for PEM and results in significant alleviation of symptoms.Therefore,following the diagnosis of PEM,immediate surgery is recommended.展开更多
文摘【目的】分析自然分娩产妇产后会阴部疼痛。【方法】选择自然生产的产妇120例,记录产妇产后的会阴部创伤情况,新生儿分娩时的胎方位及胎儿体重,采用视觉模拟评分法（VAS）对产后1 d 和产后4 d的会阴部疼痛情况进行评分。【结果】VAS 评分中,产妇产后1 d 的会阴部疼痛发生率较高,疼痛发生率为88.33%（106/120）,中重度疼痛发生率25.00%；产后4 d 会阴部疼痛发生率为25.00%（30/120）,中重度疼痛比例为1.67%；120例产妇中,16例产妇会阴部完好无损,53例产妇为Ⅰ、Ⅱ撕裂；51例产妇会阴部疼痛的危险因素分析：硬膜外分娩镇痛、自发撕裂、初产妇及会阴侧切的产妇更易出现会阴部疼痛。【结论】自然分娩产妇中会阴部疼痛情况较为常见,但是疼痛程度相对较轻,且产妇的会阴部疼痛与产妇的会阴侧切、硬膜外分娩镇痛等密切相关。
基金Supported by Medical-Engineering Cross Fund from Shanghai Jiaotong University,No.ZH2018QNB17and National Natural Science Foundation of China,No.81801400.
文摘BACKGROUND The prevalence of perineal endometriosis(PEM)is low among women with endometriosis(EM)treated by surgery.It manifests as hard or cystic nodules with pain in the perineal wounds and surrounding areas.Implantation theory is regarded as the main pathogenesis of PEM.There are few clinical studies on the incidence and clinical characteristics of PEM.This study aims to summarize the clinical data of 14 PEM cases and analyze the factors that may be related to the incubation period and pain.AIM To analyze the medical history,clinical manifestations,diagnosis,treatment and treatment effect of PEM.METHODS The present study is a case series.We collected the clinical data and follow-up data of 14 patients with PEM who visited The International Peace Maternal and Child Health Hospital Affiliated to Shanghai Jiaotong University from January 2009 to December 2019.Paired t test and Pearson correlation analysis were used for statistical analysis.P<0.05 was considered statistically significant.RESULTS The 14 patients included had a history of vaginal delivery.All patients underwent PEM lesion resection.Three patients were treated by levator ani muscle repair at the same time and 1 patient underwent extensive PEM lesion resection and anal sphincter repair.Body mass index(BMI)at delivery and BMI within 1 mo after delivery were negatively correlated with the latent period,respectively(R2=0.53/0.86,P<0.05).The average visual analog scale score in lesions at the third month after surgery was 0.57±1.28 for all patients,which was significantly lower than that prior to surgery(P<0.05).One patient relapsed during the sixth month after surgery,and to date,no recurrence occurred after the second surgery.CONCLUSION The higher the BMI during delivery and within 1 mo after delivery,the shorter the incubation period of PEM.It is very important to evaluate the location of lesions before surgery.Surgical resection of the lesion is the best treatment for PEM and results in significant alleviation of symptoms.Therefore,following the diagnosis of PEM,immediate surgery is recommended.
