剖宫产与顺产对盆底功能的影响及产后盆底肌电刺激康复治疗效果对比研究  

The influence of cesarean section and vaginal delivery on the pelvic floor function and effect of postpartum pelvic floor electromyography stimulation

作　　者：袁迎九[1] 后建丽[1] 丁文清[1] 

机构地区：[1]深圳市龙岗区妇幼保健院,广东深圳518172

出　　处：《中国医药科学》2016年第16期77-80,共4页China Medicine And Pharmacy

摘　　要：目的观察剖宫产及顺产对产妇盆底功能的影响,分析产后盆底肌电刺激康复治疗对其改善作用。方法 300例产妇根据分娩方式分为剖宫产组(n=150)和阴道顺产组(n=150),比较产后两组间盆底功能障碍性疾病(PFD)发生率差异,比较产后6周两组间盆底肌力差异及血清松弛素(RLX)水平及产妇盆底结缔组织中胶原含量差异。选择盆底肌力<3级的产妇进行产后盆底肌电刺激康复治疗,比较治疗前后盆底肌力差异。结果剖宫产盆腔器官脱垂(POP)发生率、盆底肌力受损率及PFD发生率显著低于顺产组;剖宫产组阴道横断面肌力分级显著高于顺产组,神经肌肉刺激治疗仪检测结果显示显示剖宫产组盆底Ⅰ、Ⅱ类肌纤维的肌电压高于顺产组,疲劳度则低于剖宫产组;剖宫产组血清RLX水平显著低于顺产组,产妇盆底结缔组织中胶原含量则显著高于顺产组,组间差异有统计学意义(P<0.05)。接受盆底肌电刺激康复治疗后,剖宫产组和顺产组手测阴道横断面肌力、盆底Ⅰ类肌纤维肌电压、盆底Ⅱ类肌纤维肌电压显著提升,血清RLX水平显著下降,治疗前后差异均有统计学意义(P<0.05)。结论相比于顺产,剖宫产对盆底功能造成的损伤较小,盆底肌电刺激康复治疗能有效改善PFD患者的盆底功能。Objective To study the influence of cesarean section and vaginal delivery on the pelvic floor function,and to analyze the improvement effect of postpartum pelvic floor electromyography stimulation. Methods 300 women were divided into cesarean section group （n=150） and vaginal delivery group （n=150） according to the mode of delivery,then the difference of incidence of pelvic floor dysfunction disease （PFD） among the two groups were compared,and the differences of the pelvic floor muscle strength and serum levels of RLX,collagen content in the pelvic floor connective tissue between the two groups in the 42 days after delivery were also compared.The women who pelvic floor muscle strength less than 3 level were selected for the treatment of postpartum pelvic floor electromyography stimulation rehabilitation,and the differences of the pelvic floor muscle strength before and af）er treatment were also compared. Results The incidence of pelvic organ prolapse （POP） and PFD,damage rate of pelvic floor muscle strength of cesarean section group were all less than those of vaginal delivery group.The grade of vaginal cross-sectional muscle strength of cesarean section group was higher than that of vaginal delivery group.The muscle voltage of I , II class of pelvic floor muscle fibers of cesarean section group were higher than those of vaginal delivery group,while the fatigue degree were lower than that of vaginal delivery group.The serum levels of RLX of cesarean section group was lower than that of vaginal delivery group,and collagen content of cesarean section group was higher than that of vaginal delivery group.The difference between the two groups was statistically significant （P 〈 0.05）.After the treatment of postpartum pelvic floor electromyography stimulation rehabilitation,the grade of vaginal cross-sectional muscle strength and the muscle voltage of I , II class of pelvic floor muscle fibers of both cesarean section group and vaginal delivery group were all higher than before treatment,while th

关 键 词：盆底功能 盆底肌电刺激康复治疗 剖宫产 顺产 

分 类 号：R711.5[医药卫生—妇产科学]