不同产次自然分娩对产妇分娩不良事件及盆底结构功能的影响  

Influence of different times of natural childbirth on adverse delivery events and pelvic floor structures and functions

作　　者：王小倩[1] 古立娟[1] 梁云香[1] 石尖兵[1] 罗辉[1] 刘芳宏 周蕾[1] WANG Xiaoqian;GU Lijuan;LIANG Yunxiang;SHI Jianbing;LUO Hui;LIU Fanghong;ZHOU Lei(Department of Ultrasound,The First People's Hospital of Jingmen City,Jingmen 448000,Hubei,China)

机构地区：[1]湖北省荆门市第一人民医院超声科,湖北荆门448000

出　　处：《右江医学》2021年第5期365-368,共4页Chinese Youjiang Medical Journal

摘　　要：目的探讨不同产次自然分娩对产妇分娩不良事件及盆底结构功能的影响。方法选取2018年1月至2019年1月期间于医院产科自然分娩的产妇120例。按产次不同进行分组,初产妇60例为对照组,二次自然分娩产妇60例为观察组。利用盆底超声检查观察并比较两组产妇盆底结构功能的变化。结果观察组产后直肠膨出、子宫脱垂、会阴体过度活动、尿道内口呈漏斗样的发生率分别为20.00%、50.00%、40.00%、26.67%,高于对照组初次自然分娩产妇的3.33%、23.33%、13.33%、6.67%,差异有统计学意义(P<0.05)。观察组膀胱颈活动度、最大Valsalva状态时膀胱后角、膀胱颈倾斜角、膀胱颈旋转角,以及肛提肌裂口面积均大于对照组,差异有统计学意义(P<0.001)。结论分娩可损伤膀胱尿道等盆底结构和周围支持结构,影响盆底功能,二次分娩影响更大。Objective To explore the influence of different times of natural childbirth on adverse childbirth events and pelvic floor structures and functions.Methods 120 cases of natural childbirth women in the obstetric department of the hospital between January 2018 and January 2019 were selected.They were grouped according to different times of childbirth,60 cases of primipara were selected as control group,and 60 cases of the second natural childbirth in observation group.Pelvic floor ultrasound was used to observe and compare the changes of pelvic floor structures and functions between the two groups.Results The incidence of postpartum rectal prolapse,uterine prolapse,excessive perineal movement,and funnel-like appearance of internal urethral orifice in the observation group were 20.00%,50.00%,40.00%,and 26.67%,respectively,which were higher than those in the control group(3.33%,23.33%,13.33%,6.67%,respectively),and difference was statistically significant(P<0.05).Bladder neck mobility,back bladder angle at maximum Valsalva state,bladder neck tilt angle,bladder neck rotation angle,and levator anal fissure area in the observation group were all larger than those in the control group,with significant differences(P<0.001).Conclusion Childbirth can damage pelvic floor structures such as bladder and urethra and surrounding support structures,and affect pelvic floor function.The effect of secondary delivery is greater.

关 键 词：产次 自然分娩 盆底结构 盆底功能障碍性疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714[医药卫生—诊断学]