天津地区产后盆底肌力损伤的相关因素分析  

The relative impact factors of postpartum pelvic floor muscle injury in the region of Tianjin

作　　者：高雯[1] 吕凤君[1] 张翠萍[1] 李卫芹[1] 李宝娟[1] 

机构地区：[1]天津市妇女儿童保健中心,300070

出　　处：《天津医药》2015年第7期800-803,共4页Tianjin Medical Journal

摘　　要：目的探讨不同因素对产后盆底肌力损伤的影响,为早期防治盆底功能障碍性疾病(PFD)提供临床依据。方法选取2011年12月—2014年12月参加天津市产后盆底功能筛查的产妇65 630例,采用统一的检测方法和诊断标准,由各区县妇幼保健机构对辖区内产妇进行盆底肌力测评,分析不同因素对产后盆底肌力的影响。结果产后发生肌力异常19 452例,异常率为29.6%;其中农村妇女的肌力异常率高于城市妇女(33.9%vs 27.8%),初中及以下学历的肌力异常率(34.1%)高于中专或高中(30.4%)和大专及以上学历者(27.7%),阴道手术产的肌力异常率(40.8%)高于自然产(32.5%)及剖宫产(27.2%),分娩2次及以上的肌力异常率(34.6%、31.5%)高于初次分娩(29.1%)。多因素分析显示,城市户籍、文化程度高、分娩次数少是产后肌力的保护因素,阴道手术产是危险因素。结论产后盆底肌力损伤的发生率高,在孕前及围产期加强管理,做到早防早治,可以有效减少PFD的发生。Objective To investigate the influences of different factors on postpartum pelvic floor muscle injury, andprovide clinical evidence to the early prevention of pelvic floor dysfunction（PFD）. Methods A total of 65 630 women, whoparticipated the postpartum pelvic floor function screening in Tianjin, from December 2011 to December 2014 were selectedin this study. The uniform detect methods was used in this study. The analysis based on the PFD was diagnosed by physi-cians of Women＇s and Children＇s Health Center in each district. The influences of different factors on postpartum pelvicfloor muscle were analyzed. Results There were 19 452（29.6%） women suffering from postpartum pelvic floor muscle inju-ry, with the abnormal rate 29.6%, which was higher in rural areas than that in urban areas（33.9% vs 27.8%）. The abnormalrate was higher in women with junior middle education or below（34.1%） than that in women with senior middle or polytech-nic schooling（30.4%）, and women with college or higher education（27.7%）. There was a higher abnormal rate in women withvaginal surgery delivery（40.8%） than that in women with natural delivery（32.5%） and women with caesarean section（27.2%）. The muscle abnormal rate was higher in women having given two or more than two times of deliveries（34.6%,31.5%） than those having initial delivery（29.1%）. Multiple factor analyses showed that city residency, higher education andless delivery times were protecting factors for postpartum pelvic floor muscle while vaginal surgery was a risk factor for post-partum pelvic floor muscle. Conclusion There is a high incidence of postpartum pelvic floor muscle injury in the region ofTianjin. Analyzing the risk factors and strengthening the management of pelvic floor muscle injury by early prevention or ear-ly treatment would help to reduce the incidence of PFD effectively during pre-pregnancy and perinatal periods.

关 键 词：盆底功能障碍 产后肌力损伤 筛查 影响因素 

分 类 号：R173[医药卫生—妇幼卫生保健]