不同生理阶段女性盆底功能比较  

Comparison of female pelvic floor function at different physiological stages

作　　者：朱希慧[1] 马志敏[1] 魏昂 崔江梅 陈晓[1] 孟艳岑[1] ZHU Xihui;MA Zhimin;WEI Ang;CUI Jiangmei;CHEN Xiao;MENG Yancen(Shijiazhuang Forth Hospital,Hebei Medical University Affiliated Obstetrics and Gynecology Hospital,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第四医院,河北医科大学附属妇产医院,石家庄050000

出　　处：《实用医学杂志》2022年第8期980-984,共5页The Journal of Practical Medicine

基　　金：石家庄市科学技术研究与发展计划项目(编号:201461173)。

摘　　要：目的不同生理阶段女性盆底功能和盆底器官脱垂(pelvic organ prolapse,POP)现状及差异尚不清晰,本研究对未分娩和已分娩绝经前、绝经后女性的现状进行对比分析。方法连续收集2018年5月至2020年5月就诊我院围产中心患者366例,包括120例未分娩绝经前、126例已分娩绝经前和120例绝经后女性。收集入组患者的手测肌力、盆底电生理指标和POP分度。结果卡方分析结果显示,绝经后女性的手测肌力(包括手测牛津肌力和肛提肌肌力)、Ⅱ类肌纤维肌力的异常人数百分比显著高于未分娩和已分娩绝经前组(P<0.01)。绝经后女性的阴道压力和POP分期为0级的人数占比均显著低于未分娩绝经前组(P<0.01)。经多因素logistic回归分析,自行盆底康复锻炼为手测盆底肌力下降的保护因素,分娩和绝经为手测盆底肌力和Ⅱ类肌纤维肌力异常的危险因素。分娩是POP的危险因素。结论盆底肌力异常和POP在绝经后女性中发病率增加,增加盆底康复锻炼可减少该疾病的发生。Objective The current status and differences of pelvic floor function and pelvic floor organ prolapse(POP)in women at different physiological stages have still been unclear.This study is to compare and analyze the current status of premenopausal nullipara and parturients and postmenopausal women.Methods 366 female patients who had visited the perinatal center of our hospital from May 2018 to May 2020 were enrolled in this study,including 120 premenopausal nullipara,126 premenopausal parturients,and 120 postmenopausal women.The modified oxford staging(MOS),levator ani testing(LAT),pelvic floor electrophysiological indexes and POP index were collected in all the women.Results Chi-square test showed that the percentage of abnormality in MOS,LAT and type Ⅱ muscle fiber strength was significantly higher in postmenopausal women than in premenopausal nullipara and parturients(P<0.01).The proportion of postmenopausal women whose vaginal pressure and POP staging were zero was significantly lower than that of premenopausal nullipara(P<0.01).Multiple Logistic regression analysis showed that self-pelvic floor rehabilitation exercise was the protective factor of MOS and LAT,while childbirth and menopause were the risk factors of MOS,LAT and type Ⅱ muscle fiber strength abnormalities.Childbirth was the risk factor for POP.Conclusions The incidence of abnormal pelvic floor muscle strength and POP increased in postmenopausal women.Pelvic floor rehabilitation exercise can reduce the occurrence of this disorder.

关 键 词：盆底功能 电生理指标 盆底器官脱垂 分娩 绝经 

分 类 号：R711.7[医药卫生—妇产科学]