不同分娩方式对初产妇产后肛门括约肌复合体、盆底肌力及性生活的影响  

Effects of different delivery modes of primiparas on anal sphincter complex,pelvic floor muscle strength,and sexual life

作　　者：罗敏[1] 张文先[1] 侯宇[1] LUO Min;ZHANG Wenxian;HOU Yu(Guangyuan Central Hospital,Guangyuan,Sichuan Province,628017)

机构地区：[1]四川省广元市中心医院,628017

出　　处：《中国计划生育学杂志》2022年第11期2517-2521,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨不同分娩方式对初产妇产后肛门括约肌复合体、盆底肌力及性生活的影响。方法:选取2020年6月-2021年6月在本院分娩的147例初产妇,根据不同分娩方式分为阴道分娩组(84例)和剖宫产组(63例)。比较两组产后12周盆底肌力及《女性性生活质量问卷》评分,行会阴盆底三维超声检查评估肛门括约肌复合体情况(肛门内括约肌近端平面、中部平面、远端平面及肛门外括约肌远端平面3、6、9、12点方向的厚度,耻骨直肠肌中部平面4、8点方向的厚度)。比较两组产后并发症发生情况。结果:剖宫产组肛门内括约肌近端平面在6、12点方向的厚度,中部平面在12点方向的厚度均高于阴道分娩组,肛门外括约肌远端平面在12点方向的厚度高于阴道分娩组(均P<0.05)。剖宫产组Ⅰ类肌纤维(12.36±1.40μV)、Ⅱ类肌纤维肌电值(19.62±2.04μV)均高于阴道分娩组(11.47±1.32μV、17.78±2.45μV),疲劳度(7.67±1.32、7.33±1.12)%均低于阴道分娩组(8.51±1.15、8.64±1.14)%,女性性生活质量问卷各项评分均高于阴道分娩组(均P<0.05)。产后并发症发生情况(8.3%、6.3%)无差异(P>0.05)。结论:与阴道分娩方式相比,剖宫产对初产妇产后肛门括约肌复合体、盆底肌力及性生活的影响较小。Objective:To explore the effects of different delivery modes of primiparas on their anal sphincter complex,pelvic floor muscle strength,and sexual life.Methods:A total of 147 primiparas were selected and were divided into group A(84 cases with vaginal delivery)and group B(63 cases with cesarean section)according to different delivery modes between June 2020 and June 2021.The pelvic floor muscle strength and female sexual life quality questionnaire score of the primiparas in the 12th week after delivery were compared between the two groups.The three-dimensional ultrasound examinations of perineum and pelvic floor were conducted to evaluate the situation of the anal sphincter complexes of the primiparas in both groups,which included the proximal plane,middle plane,and distal plane of internal sphincter muscle of anus,the thickness of distal plane in external sphincter muscle of anus at 3,6,9 and 12 o'clock,the thickness of middle plane in puborectalis at 4 and 8 o'clock.The occurrence of postpartum complications of the primiparas was compared between the two groups.Results:The thickness of proximal plane in internal sphincter muscle of anus at 6 and 12 o'clock,and thickness of middle plane at 12 o'clock of the primiparas in group B were significantly higher than those of the primiparas in group A(P<0.05).The thickness of distal plane in external sphincter muscle of anus at 12 o'clock of the primiparas in group B was significantly higher than that of the primiparas in group A(P<0.05).The EMG values of typeⅠ(12.36±1.40μV)and typeⅡmuscle fibers(19.62±2.04μV)of the primiparas in group B were significantly higher than those(11.47±1.32μV and 17.78±2.45μV)of the primiparas in group A.The degrees of fatigue of typeⅠand typeⅡmuscle fibers(7.67±1.32 and 7.33±1.12)of the primiparas in group B were significantly lower than those(8.51±1.15 and 8.64±1.14)of the primiparas in group A(P<0.05).The scores of female sexual life quality questionnaire of the primiparas in group B were significantly higher than those

关 键 词：产后恢复 阴道分娩 剖宫产 肛门括约肌复合体 盆底肌力 性生活 

分 类 号：R714.6[医药卫生—妇产科学]