摘要
目的获得中国初产妇产后早期盆底电生理指标及盆腔器官脱垂分度情况及危险因素分析。方法自2011年10月在广西、广东、河北、河南、山西5省开展多中心横断面研究,在产后6周对产妇基本情况、产科情况及盆底电生理指标和盆腔器官脱垂分度（POP-Q）数据进行采集和统计学分析。结果共入组1327例初产妇,产后6周的盆底电生理指标显示,Ⅰ类肌肌力3级以上的占47.5%,Ⅱ类肌肌力3级以上的占43.6%,盆底动态压力为（61.8±29.2）cm H2O。A3反射正常率为66.7%。分娩时会阴裂伤（OR=1.48;95%CI 1.11~1.97）和工作体位以站位为主（OR=1.57;95%CI 1.06~2.33）是发生Ⅰ类肌早期肌力下降的危险因素。盆底障碍性疾病家族史是Ⅰ类肌和Ⅱ类肌疲劳度异常的危险因素。盆腔器官脱垂分度中,第二产程延长是后壁Ap点（OR=10.02,95%CI 1.88~53.49）和Bp点（OR=5.57,95%CI 1.19~26.01）下移的危险因素,会阴裂伤是中盆腔C点（OR=1.54,95%CI 1.14~2.09）和D点（OR=2.61,95%CI 1.51~4.53）下移的危险因素。结论约半数初产妇产后早期盆底电生理指标处于受损状态,会阴裂伤和家族遗传史是其危险因素。第二产程延长和会阴裂伤是产后早期POP-Q分度位点下移的危险因素。
Objective To describe the pelvic floor electrical physiological indicators and pelvic organ prolapse quantification in primiparous women. Methods A multicenter cross-sectional study was carried out in five provinces. The baseline demographics, obstetric data, pelvic floor electrical physiological indexes and pelvic organ prolapse quantification（POP- Q） measurement were collected and analysed.Results Totally 1327 primipara were included in our trial,and the indicators in 6 weeks after delivery were as follows： the strength of type Ⅰ muscle was 47.5% above 3grade;the strength of type Ⅱ muscle was 43.6% above 3grade;pelvic floor dynamic pressure was 61.8 ± 29.2 cm H2 O. 66.7% was normal in A3 reflection. The deterioration of type Ⅰ muscle strength was associated with perineal laceration（OR=1.48; 95% of CI, 1.11 to 1.97） and standing job position（OR=1.57; 95% of CI, 1.06 to 2.33）.Family history of pelvic floor disorder was risk factor of the fatigue index of type Ⅰ and type Ⅱ muscle. In POPQ measurement, the prolonged second stage of labor showed associations with POP- Q point Ap（OR=10.02,95% CI 1.88-53.49） and point Bp（OR =5.57, 95% CI 1.19-26.01）. Perineal laceration was associated with C point（OR=1.54, 95% CI 1.14-2.09） and D point（OR=2.61, 95% CI 1.51-4.53）. Conclusion Pelvic floor electrical physiological indexes are reduced in about half of primipara in early postpartum stage. Perineal laceration and family history are the risk factors. The prolonged second stage of labor and perineal laceration are associated with the decline of POP-Q points.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2015年第5期433-439,共7页
Chinese Journal of Practical Gynecology and Obstetrics
基金
中华预防医学会中国妇女盆底功能障碍防治专项资金(20120102)
十二五国家科技支撑项目妇女常见多发疾病防治研究(2014BAI05B02)
关键词
初产妇
盆底功能障碍性疾病
盆底电生理指标
盆腔器官脱垂分度
primipara
pelvic floor dysfunction
pelvic floor electrical physiological indexes
pelvic organ prolapse quantification
