足月分娩产妇产后早期盆底功能状况分析  

Analysis of early postpartum pelvic floor function in full-term delivery women

作　　者：乔庆[1] 刘彩红[1] 韩卫华[1] 冯海芹[1] Qiao Qing;Liu Caihong;Han Weihua;Feng Haiqin(The First Obstetrics Department of Handan Central Hospital,Handan Hebei 056000,P.R.China)

机构地区：[1]邯郸市中心医院产一科,河北邯郸056002

出　　处：《中国计划生育和妇产科》2023年第1期19-24,共6页Chinese Journal of Family Planning & Gynecotokology

基　　金：河北省医学科学研究课题(项目编号:20211732,20220566)。

摘　　要：目的探讨足月分娩的产妇产后早期(6~8周)盆底肌肌电值变化,分析产后早期压力性尿失禁(stress urinary incontinence,SUI)、盆腔器官脱垂(pelvic organ prolapse,POP)的危险因素。方法选取2020年11月至2021年11月在邯郸市中心医院产后复查的504例足月分娩产妇作为研究对象,按照分娩方式分为剖宫产组和阴道分娩组,比较两组产妇产后早期盆底肌的肌电值情况,分析产妇产后早期SUI及POP的发生情况及其危险因素。结果(1)剖宫产组产妇产后早期盆底肌前/后静息阶段、快肌阶段、慢肌阶段及耐力阶段的肌电值(10.07,8.63,53.11,33.93,30.08)均明显高于阴道分娩组(6.20,5.11,37.62,24.77,22.55),差异均有统计学意义(P<0.05);剖宫产组产妇产后早期盆底肌前/后静息阶段的肌电值异常率(87.8%,78.9%)高于阴道分娩组(79.1%,62.2%),其快肌阶段、慢肌阶段及耐力阶段的肌电值异常率(24.8%,56.1%,50.0%)均低于阴道分娩组(56.2%,74.0%,74.4%),差异均有统计学意义(P<0.05)。(2)与剖宫产相比,阴道分娩增加了产妇产后早期SUI及POP的发生风险;与初产妇相比,再次分娩的产妇产后早期SUI的发生风险增加;与产前体质量指数(BMI)<24 kg/m^(2)的产妇相比,产前24 kg/m^(2)≤BMI<28 kg/m^(2)及产前BMI≥28 kg/m^(2)的产妇产后早期POP的发生风险均明显增加。结论(1)两种分娩方式产后早期盆底肌肌电值均有不同程度的异常改变,阴道分娩对盆底肌的收缩功能损伤更大,剖宫产组盆底肌放松功能更差;(2)分娩方式及产次是产后早期SUI发生的影响因素,分娩方式及产前BMI是产后早期POP发生的影响因素。Objective To explore the changes of pelvic floor electromyoelectric value in parturient parturients with full term delivery in early postpartum period(6~8 weeks),and analyze the risk factors of stress urinary incontinence(SUI)and pelvic organ prolapse(POP).Methods A total of 504 women with full term delivery who were reexamined in Handan Central Hospital from November 2020 to November 2021 were selected as the research objects.They were divided into cesarean section group and vaginal delivery group according to the delivery mode.The electromyoelectric value of pelvic floor muscle in the early postpartum period was compared between the two groups,and the occurrence of SUI and POP in the early postpartum period and its risk factors were analyzed.Results(1)The electromyoelectric values of parturients in the cesarean section group(10.07,8.63,53.11,33.93,30.08)were significantly higher than those in the vaginal delivery group(6.20,5.11,37.62,24.77,22.55)at the resting stage,fast muscle stage,slow muscle stage and endurance stage of pelvic floor muscle in the early postpartum period.The differences were statistically significant(P<0.05).The abnormal rates of electromyography(EMG)value in the pre-and post-resting stages of pelvic floor muscle in the early postpartum period of the cesarean section group(87.8%,78.9%)were higher than those in the vaginal delivery group(79.1%,62.2%).The abnormal rates of EMG value in the fast muscle stage,slow muscle stage and endurance stage(24.8%,56.1%,50.0%)were significantly lower than those in the vaginal delivery group(56.2%,74.0%,74.4%),and the differences were statistically significant(P<0.05).(2)Compared with cesarean section,vaginal delivery increased the risk of early postpartum SUI and POP;Compared with first-time mothers,women who delivered again had an increased risk of early postpartum SUI.Compared with pregnant women with prenatal body mass index(BMI)<24 kg/m^(2),the risk of early postpartum POP was significantly increased in pregnant women with prenatal 24 kg/m^(2)≤BMI<28

关 键 词：盆底功能 肌电值 剖宫产 阴道分娩 盆腔器官脱垂 压力性尿失禁 

分 类 号：R711.7[医药卫生—妇产科学] R714.1[医药卫生—临床医学]