摘要
目的:探讨分娩方式对初产妇盆底功能和结构的影响。方法:选取2018年8月-2019年12月在贵州航天医院产科分娩并于产后6-8周复查的480例足月初产妇为研究对象,利用盆底肌电仪及肌电生物反馈仪在产后6w、12w、24w三个时间点对产妇的盆底肌电信号进行采集、分析,同时记录产妇盆底肌力。随访记录产妇盆腔脏器脱垂(Pelvic organ prolapse,POP)及远近期并发症情况。结果:(1)与剖宫产组相比,顺产组产妇在产后6 w、12 w、24 w时的前静息平均肌电值、快肌最大肌电值、混合肌平均肌电值、慢肌平均肌电值均显著较高(P<0.05),同时顺产组产妇的Ⅰ类肌纤维、Ⅱ类肌纤维肌力均显著较低(P<0.05);(2)顺产组、剖宫产组的POP总体发生率分别为41.97%(115/274)、25.73%(53/206),差异具有统计学意义(P=0.018),顺产组产妇的阴道前壁脱垂的发生率高于剖宫产组(P=0.030),顺产组产妇的阴道后壁脱垂、子宫脱垂的发生率高于剖宫产组,但差异无统计学意义(P>0.05)。(3)顺产组与剖宫产组产妇的近期并发症发生率分别为27.37%(75/274)、20.87%(43//206),远期并发症发生率分别为8.76%(24/274)、3.40%(7/206),两组产妇的远期(X^(2)=2.421,P=0.120)及近期(X^(2)=1.083,P=0.298)并发症发生率均无明显差异。结论:与经阴道分娩相比,剖宫产可明显降低产妇POP的发生率,保护盆底功能。
Objective:To investigate the effect of delivery mode on pelvic floor function and structure of primipara.Methods:480 primiparas were selected as the research object,including 90 cases in vaginal delivery group and 90 cases in cesarean section.Pelvic floor electromyography and electromyography biofeedback instrument were used to collect and analyze the pelvic floor electromyography signals of primiparas at 6 W,12 W and 24 w postpartum.At the same time,the pelvic floor muscle strength was recorded.During the follow-up,the pelvic organ prolapse(POP)and far and near-term complications were recorded.Results:Compared with the cesarean section group,the average EMG value of pre rest,maximum EMG value of fast muscle,average EMG value of mixed muscle and average EMG value of slow muscle in the spontaneous delivery group were significantly higher at 6W,12W and 24W postpartum(P<0.05).At the same time,the muscle strength of class I and class II muscle fibers in spontaneous labor group was significantly lower(P<0.05).The overall incidence of pop in spontaneous delivery group and cesarean section group were 41.97%and 25.73%respectively.At the same time,the incidence of vaginal anterior wall prolapse in spontaneous delivery group was higher than that in cesarean section group.The short-term complication rates of spontaneous delivery group and cesarean section group were 27.37%and 20.87%respectively,and the long-term complication rates were 8.76%and 3.40%respectively.There was no significant difference of side effects between the two groups.Conclusion:Compared with vaginal delivery,cesarean section can significantly reduce the incidence of POP,protect the pelvic floor function,facilitate the early functional rehabilitation and improve the quality of life.
作者
陶柳
刘显历
毕云凤
Tao Liu;Liu Xian-li;Bi Yun-feng(Department of Gynecology,Guizhou Aerospace Hospital,Zunyi 563000,Guizhou,China)
出处
《四川生理科学杂志》
2021年第9期1482-1485,共4页
Sichuan Journal of Physiological Sciences
基金
遵义市科技计划项目(编号:遵汇科合社字[2018]120号)
。
关键词
分娩方式
经阴道分娩
剖宫产
盆底功能
Mode of delivery
Vaginal delivery
Cesarean section
Pelvic floor function
