摘要
目的 探讨分娩镇痛对初产妇产后盆底组织功能的近期影响.方法 回顾分析我院2017年1月~2018年12月经阴分娩的初产妇285例.分为A(自然分娩组)、B(分娩镇痛第二产程<2h组)、C(2h≤分娩镇痛第二产程<3h组)三组,其中A组115例,B组100例,C组70例.三组产妇均为单胎,初产,均无内、外科合并症,无阴道侧切与助产,三组年龄(25~34岁)、孕周(37~42周)、第一产程时间(≤24h)、产妇分娩前体重指数(19~25kg/m 2)、新生儿体重(2500~4000g)比较差异均无统计学意义(P>0.05).三组产妇均在分娩后6~8周由专人对其进行盆底功能评估,包括盆腔脏器脱垂的POP-Q分度评估,布里斯托问卷(ICIQ-FLUTS)尿失禁诊断,利用生物反馈盆底康复仪对盆底肌群Ⅰ、Ⅱ型肌纤维功能进行评估.结果 (1)B组盆腔器官脱垂程度较A组减轻,差异有统计学意义(P<0.05);B组盆腔器官脱垂程度较C组减轻,差异有统计学意义(P<0.05).(2)A、B、C三组尿失禁发生率差异无统计学意义(P>0.05).(3)B组盆底肌持续收缩值和快速收缩值均高于A组(P<0.05),B组盆腔肌持续收缩值和快速收缩值均高于C组(P<0.05).结论 ?分娩镇痛可以减轻经阴分娩对盆底组织的损伤,但随着第二产程时间的延长,盆底组织损伤程度增加,因此要尽量避免第二产程的延长.
Objective To investigate the short-term effects of delivery analgesia on postpartum pelvic floor tissue function in primipara.Methods A retrospective analysis of 285 primiparous women undergoing vaginal delivery in our hospital from January 2017 to December 2018 was performed.Patients were divided into three groups:A(natural delivery group),B(second stage of delivery analgesia<2h group),C(2h≤second stage of delivery analgesia<3h group),including 115 cases in group A,100 cases in group B and 70 cases in group C.All women in the three groups were singleton,primiparous delivery,no internal and surgical complications,no lateral episiotomy and midwifery.There were no significant differences in age(25-34 years old),gestational weeks(37-42 weeks),time of the first stage of labor(≤24 h),body mass index before delivery(19-25kg/m2)and neonatal weight(2500-4000g)(P>0.05).All women in the three groups were evaluated for pelvic floor function by special personnel 6-8 weeks after delivery,including POP-Q index assessment of pelvic organ prolapse and Bristol questionnaire(ICIQ-FLUTS)diagnosis of urinary incontinence.The biofeedback pelvic floor rehabilitation instrument was used to evaluate the function of typeⅠandⅡmuscle fibers of pelvic floor muscles.Results(1)The degree of pelvic organ prolapse in group B was less than that in group A,and the difference was statistically significant(P<0.05).The degree of pelvic organ prolapse in group B was less than that in group C,and the difference was statistically significant(P<0.05).(2)There was no significant difference in the incidence of urinary incontinence between groups A,B and C(P>0.05).(3)The sustained contraction value and rapid contraction value of pelvic floor muscles in group B were higher than those in group A(P<0.05).The sustained contraction value and rapid contraction value of pelvic muscle in group B were higher than those in group C(P<0.05).Conclusion Delivery analgesia can alleviate the damage of pelvic floor tissue during vaginal delivery,but with the extension of the second stage of labor,the degree of pelvic floor tissue damage increases,thus we should try to avoid the extension of the second stage of labor.
作者
王金彩
郭明彩
WANG Jincai;GUO Mingcai(Department of Anesthesiology,Qingzhou Maternal and Child Health Hospital,Shandong,Qingzhou 262500,China;Department of Obstetrics and Gynecology,Qingzhou Maternal and Child Health Hospital,Shandong,Qingzhou 262500,China)
出处
《中国医药科学》
2020年第6期104-107,共4页
China Medicine And Pharmacy
关键词
分娩镇痛
自然分娩
盆底功能障碍性疾病
第二产程时间
Delivery analgesia
Natural delivery
Pelvic floor dysfunction disease
Second stage of labor
