摘要
目的:比较两次分娩史不同分娩方式经产妇分娩间隔时间对盆底肌肉Ⅰ、Ⅱ类肌纤维肌力的影响,探究最佳分娩间隔时间。方法:回顾性收集2017年6月-2021年6月于本院进行盆底功能检查的二胎产后复查产妇2593例,收集相关临床数据,并进行盆底表面肌电评估。依据不同分娩方式两次分娩间隔时间与盆底肌肉Ⅰ、Ⅱ类肌纤维肌力进行曲线拟合,得出分娩间隔时间-肌力的函数方程,通过绘制受试者工作特征曲线(ROC)计算最大曲线下面积和相对误差率验证函数方程的准确性。结果:2593例产妇,以两次分娩方式分组为顺产-顺产组648例;顺产-剖宫产组528例;剖宫产-剖宫产组1400例;剖宫产-顺产组17例。曲线拟合为二次曲线,取Ⅰ类肌纤维肌力>35μV、Ⅱ类肌纤维肌力>40μV时适合的分娩间隔时间分别为,顺产-顺产组为6~8年,顺产-剖宫产组为4~9年,剖宫产-剖宫产组为2~10年;其中二次曲线达到峰值的年份为:顺产-顺产组7~8年,顺产-剖宫产组7~8年,剖宫产-剖宫产组6年。各组Ⅰ、Ⅱ型肌纤维肌力曲线的最大曲线下面积均>0.6(均P<0.05),相对误差率平均为4.909%。结论:本研究从维护骨盆腔各项功能的方面综合考量,生育间隔时间在6~8年适宜。
Objective:To compare the effects of the interval time of two deliveries of puerpera with different delivery modes on the muscle strength of their class Ⅰ and Ⅱ muscle fibers of pelvic floor muscles,and to explore the optimal delivery interval.Methods:A total of 2593 puerpera with second-child women who had undergone pelvic floor function examination from June 2017 to June 2021 were collected retrospectively.The relevant clinical data of the puerpera were collected,and the pelvic floor surface electromyography of the puerpera was evaluated.According to the interval time of two deliveries of different delivery methods and the muscle strength of pelvic floor muscle fibers of class Ⅰ and Ⅱ of the puerpera,the curve fitting was conducted and functional equation of the interval time of delivery and muscle strength was obtained.The accuracy of the functional equation was verified by drawing receiver operator characteristic(ROC)curve and calculating the maximum area under the curve and the relative error rate.Results:2593 puerpera were divided into different groups based on the two deliveries modes,including 648 cases with vaginal-vaginal delivery,528 cases with vaginal delivery-cesarean section,1400 cases with cesarean-cesarean section,and 17 cases with cesarean-vaginal delivery.The curve fitting results showed that it was a quadratic curve.The muscle force of class Ⅰ muscle fibers was>35μV and class Ⅱ muscle fiber strength>40μV,the appropriate intervals included the vaginal-vaginal delivery group of 6-8 years,the vaginal-cesarean section group of 4-9 years,and the cesarean-cesarean section group of 2-10 years.The years of the conic curve reached to the peak included 7-8 years for the puerpera with vaginal-vaginal delivery group,7-8 years for the puerpera with vaginal-cesarean section,and 6 years for the puerpera with cesarean-cesarean section.The maximum area under the curve of the muscle strength curve of Class Ⅰ and Ⅱ muscle fibers in these groups were all>0.6(all P<0.05),with the average relative error rate of 4.909%.Conclusion:This study considers the maintenance of pelvic functions of the puerpera,and the appropriate interval between two deliveries is 6-8years.
作者
李芹
陈艳萍
范静
张媛媛
LI Qin;CHEN Yanping;FAN Jing;ZHANG Yuanyuan(Northwest Women's and children's Hospital,Xi'an,Shaanxi Province,710061)
出处
《中国计划生育学杂志》
2023年第11期2752-2757,共6页
Chinese Journal of Family Planning
关键词
经产妇
分娩方式
分娩间隔时间
盆底肌纤维肌力
盆底功能障碍性疾病
Puerpera
Mode of delivery
Interval between two deliveries
Pelvic floor muscle fiber muscle strength
Pelvic floor dysfunction disease
