分娩镇痛对足月初产女性产后盆底结构的近期影响  

Recent impact of labor analgesia on pelvic floor structures of primipara at term in postpartum

作　　者：徐净[1] 黄泽萍[1] 郑志娟[1] 张奥华[1] 张新玲[1] XU Jing;HUANG Zeping;ZHENG Zhijuan;ZHANG Aohua;ZHANG Xinling(Department of Ultrasound,the Third Affiliated Hospital,Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院超声科,广东广州510630

出　　处：《中国医学影像技术》2022年第11期1690-1693,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的 观察分娩镇痛对足月初产女性产后盆底结构的近期影响。方法 回顾性分析230名于产后6~8周接受经会阴实时三维盆底超声检查的足月初产女性,根据是否接受分娩镇痛将其分为分娩镇痛组(n=70)和对照组(n=160);对比观察组间一般资料、产程、静息态、最大瓦尔萨尔瓦动作及盆底肌收缩状态下盆底超声参数,分析分娩镇痛对其盆底结构的影响。结果 分娩镇痛组与对照组受试者年龄、孕次、体质量指数(BMI)、新生儿体质量及产程差异均无统计学意义(P均>0.05)。静息态及最大瓦尔萨尔瓦动作下,组间膀胱颈位置、膀胱位置、子宫位置及直肠壶腹部位置差异均无统计学意义(P均>0.05);最大瓦尔萨尔瓦动作下,组间膀胱颈移动度及肛提肌裂孔面积差异亦无统计学意义(P均>0.05)。2组受试者肛提肌撕脱发生率及肛门内/外括约肌损伤率差异均无统计学意义(P均>0.05)。结论 分娩镇痛对足月初产女性产后早期盆底结构无明显影响。Objective To observe the recent impact of labor analgesia on pelvic floor structures of primipara at term in postpartum. Methods Data of 230 primiparas at term who underwent real-time three-dimensional pelvic floor ultrasound 6—8 weeks after delivery were retrospectively analyzed. The primiparas were divided into labor analgesia group(n=70) and control group(n=160) according to whether the delivery analgesia performed or not. The general data, labor duration and pelvic floor ultrasound parameters of pelvic floor muscles at resting-state, under the maximum Valsalva maneuver and contraction state were observed and compared between groups, and the impact of labor analgesia on pelvic floor structures were analyzed. Results There was no significant difference of age, gravidity, body mass index(BMI), neonatal body mass nor labor duration between groups(all P>0.05). No significant difference of the position of bladder neck, bladder, uterus nor ampulla of rectum at resting-state and under maximum Valsalva maneuver was found between groups(all P>0.05), nor of bladder neck movement and levator ani fissure area under the maximum Valsalva maneuver(both P>0.05). There was no significant difference of the incidence of levator ani avulsion, the injury rate of internal/external anal sphincter between groups(both P>0.05). Conclusion The labor analgesia had no significant recent impact on pelvic floor structures of primipara at term in postpartum.

关 键 词：分娩 镇痛 骨盆底 超声检查 

分 类 号：R714.3[医药卫生—妇产科学] R445.1[医药卫生—临床医学]