盆腔脏器脱垂定量分度法评价不同分娩方式初产妇产后盆底损伤  

Evaluation of pelvic floor injury in primiparas with different delivery modes by Pelvic Organ Prolapse Quantification

作　　者：张继红[1] 梁旭霞[1] 张春[1] ZHANG Ji-hong;LIANG Xu-xia;ZHANG Chun(Department of Obstetrics, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China)

机构地区：[1]广西壮族自治区人民医院产科,南宁530021

出　　处：《中国临床新医学》2021年第5期473-476,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：南宁市青秀区科技计划项目(编号:2019032)。

摘　　要：目的应用基于盆腔脏器脱垂定量分度法(POP-Q)评分系统对不同分娩方式初产妇产后盆底损伤进行评价。方法选取2016-11~2019-12该院妇产科分娩的初产妇,根据分娩方式分为剖宫产组(观察组)和阴道分娩组(对照组),每组120例,于产后6周对两组产妇行盆底功能检测,并进行POP-Q评分,比较两组盆底电诊断及压力性尿失禁(SUI)发生率。结果观察组POP-Q评分指标中阴道前壁中线离处女膜缘3 cm处(Aa)、阴道前壁脱出离处女膜最远处(Ba)、阴道后壁中线离处女膜缘3 cm处(Ap)、阴道后壁脱出离处女膜最远处(Bp)、生殖道裂隙(GH)长度、会阴体(PB)长度、阴道总长度(TVL)均优于对照组,差异有统计学意义(P<0.05),两组D点水平比较差异无统计学意义(P>0.05)。观察组阴道前壁脱垂、阴道后壁脱垂分度低于对照组(P<0.05),两组子宫脱垂分度比较差异无统计学意义(P>0.05)。两组产后SUI、阴道压力异常、肌肉疲劳度异常、盆底肌力异常发生率比较差异均无统计学意义(P>0.05)。结论两种分娩方式初产妇产后近期子宫脱垂率与分度、SUI发生率均无明显差异,结合POP-Q评分提示剖宫产对产后盆底功能影响更小。Objective To evaluate the pelvic floor injury in primiparas with different delivery modes by Pelvic Organ Prolapse Quantification(POP-Q)scoring system.Methods The primiparas giving birth in the Department of Obstetrics and Gynecology,the People′s Hospital of Guangxi Zhuang Autonomous Region,from November 2016 to December 2019 were selected and divided into cesarean section group(observation group)and vaginal delivery group(control group)according to different delivery modes,with 120 cases in each group.Pelvic floor function test and POP-Q score were performed in the two groups 6 weeks after delivery,and pelvic floor electric diagnosis and the incidence of stress urinary incontinence(SUI)were compared between the two groups.Results The POP-Q scores of the observation group were better than those of the control group in the following aspects:the middle line of the anterior wall of the vagina 3cm away from the edge of the hymen(Aa),the farthest distance of the anterior wall of the vagina from the edge of the hymen(Ba),the middle line of the posterior wall of the vagina 3cm away from the edge of the hymen(Ap),the farthest distance of the posterior wall of the vagina from the hymen(Bp),the length of the genital hiatus(GH),the length of the perineal body(PB),and the total vaginal length(TVL),with statistically significant differences between the two groups(P<0.05).However,there were no significant differences in the D-point level between the two groups(P>0.05).The prolapse grades of anterior vaginal wall and posterior vaginal wall in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the prolapse grade of the uterus between the two groups(P>0.05).There were no significant differences in the incidence of postpartum SUI,abnormal vaginal pressure,abnormal muscle fatigue degree and abnormal pelvic floor muscle strength between the two groups(P>0.05).Conclusion In the immediate postpartum period,there are no significant differences in the uterine prolapse rate a

关 键 词：盆腔脏器脱垂定量分度法 初产产妇 产后期 

分 类 号：R714[医药卫生—妇产科学]