超声评估会阴侧切对初产妇前盆腔的近期影响  

Evaluate the short-term effects of episiotomy on the anterior compartment of primiparas by Pelvic Floor Ultrasound

作　　者：李百玲[1] 唐佳松 张锐[1] 王婷[1] 吕小娟[2] 

机构地区：[1]长春市妇产医院超声科,吉林长春130042 [2]长春市妇产医院盆底诊治中心,吉林长春130042

出　　处：《中国妇幼保健》2018年第22期5280-5282,共3页Maternal and Child Health Care of China

基　　金：吉林省卫生计生科技创新自筹经费项目(2016ZC004)

摘　　要：目的应用盆底超声评估经阴道分娩会阴侧切术对初产妇前盆腔的近期影响。方法选取2017年来该院复查的经阴道分娩初产妇398例,复诊时间为产后6~8周。其中会阴侧切组212例,非会阴侧切组186例。应用盆底超声在静息状态及最大Valsalva动作后分别测量两组产妇的膀胱颈、膀胱后壁至耻骨联合后下缘距离,计算膀胱颈移动度、测量膀胱后角、尿道旋转角,观察有无尿道内口漏斗形成。结果会阴侧切组与非会阴侧切组压力性尿失禁发生率分别为28.77%、27.96%,两组比较差异无统计学意义(P>0.05);会阴侧切组与非会阴侧切组膀胱膨出率分别为91.03%、88.71%,差异无统计学意义(P>0.05);会阴侧切组膀胱颈活动度、膀胱后角、尿道旋转角分别为(2.19±0.95)cm、(145.5±20.5)°、(51.4±11.8)°,非会阴侧切组膀胱颈活动度、膀胱后角、尿道旋转角分别为(2.06±0.87)cm、(138.3±19.8)°、(48.46±12.6)°,两组比较差异均无统计学意义(均P>0.05)。会阴侧切组与非会阴侧切组尿道内口漏斗形成率分别为17.9%、16.1%,两组比较差异无统计学意义(P>0.05)。结论在经阴道分娩过程中会阴侧切不能对近期盆底功能起到保护作用。Objective To evaluate the short-term effects of episiotomy on the anterior compartment of primiparas by Pelvic Floor Ultrasound.Methods 398 primiparas in 6-8 weeks after vaginal birth were selected from Janurary 2017 to December 2017 in Changchun Obstetrics and Gynecology Hospital.The primiparas were divided into episiotomy group(212 women)and non-episiotomy group(186 women).The parameters of resting and Valsalva condition were measured respectively,including the distance from the lowest point of the posterior wall of urinary bladder to the reference line,bladder neck position,the bladder neck descent(BND),posterior urethrovesical angle,urethral rotation angle;and observed the existence of bladder neck funneling.ResultsThe incidence rate of stress urinary incontinence in two groups were 28.77%and 27.96%,the difference had no statistical significance(P>0.05).The rate of vesicocele in two groups were91.03%and 88.71%,there was no significant difference between the two groups(P>0.05).The bladder neck descent,posterior urethrovesical angle and the urethral rotation angle of the episiotomy group were(2.19±0.95)cm,(145.5±20.5)°,(51.4±11.8)°.The bladder neck descent,posterior urethrovesical angle and the urethral rotation angle of the non-episiotomy group were(2.06±0.87)cm,(138.3±19.8)°,(48.46±12.6)°.There were no statistical signficance differences between the two groups(P>0.05).The incidence rate of bladder neck funneling in two groups were 17.9%and 16.1%,the difference had no statistical significance(P>0.05).ConclusionEpisiotomy could not play a protective role on recent pelvic floor function during vaginal delivery.

关 键 词：会阴侧切 压力性尿失禁 膀胱膨出 膀胱尿道后角 膀胱颈活动度 尿道旋转角 

分 类 号：R714[医药卫生—妇产科学]