不同分娩方式对初产妇产后早期盆底肌电位及肌力的影响  

Effect of different delivery modes on pelvic floor muscle potentialand muscle strength of primiparas in early postpartum period

作　　者：徐静 王旭[1] 房桂英[1] 黄丽霞[1] 魏旭静 XU Jing;WANG Xu;FANG Gui-ying;HUANG Li-xia;WEI Xu-jing(Department of Obstetrics and Gynecology,The First Hospital of Hebei Medical University,Shijiazhuang Hebei 050051,China)

机构地区：[1]河北医科大学第一医院妇产科,河北石家庄050051

出　　处：《蚌埠医学院学报》2023年第2期190-194,共5页Journal of Bengbu Medical College

基　　金：河北省卫生健康委医学科学研究课题计划(20200123)。

摘　　要：目的:探讨不同分娩方式对初产妇产后早期盆底肌电位及肌力的影响。方法:自2018年9月起选取于河北医科大学第一医院产科产检、分娩,并在盆底治疗中心接受产前、产后盆底功能检查的初产妇进行前瞻性研究。根据分娩方式分为阴道分娩组、急诊剖宫产组和择期剖宫产组,阴道分娩组进一步分为会阴侧切组组和非会阴侧切组。分别在孕36~38周和产后6~8周对盆底肌最大肌电位、Ⅰ及Ⅱ类肌纤维肌力及疲劳度(%)数值进行定量测定。结果:截至2019年8月共入组221例产妇,阴道分娩组139例(会阴侧切组61例,非会阴侧切组78例)、急诊剖宫产组27例和择期剖宫产组55例。孕36~38周时,阴道分娩组、急诊剖宫产组和择期剖宫产组产妇盆底肌最大肌电位、Ⅰ及Ⅱ类肌纤维肌力及疲劳度水平差异均无统计学意义(P>0.05)。产后6~8周时,阴道分娩组盆底肌最大肌电位、Ⅰ及Ⅱ类肌纤维肌力及疲劳度均低于急诊剖宫产组和择期剖宫产组(P<0.05~P<0.01);会阴侧切组与非会阴侧切组比较最大肌电位、Ⅰ及Ⅱ类肌纤维肌力及疲劳度水平差异无统计学意义(P>0.05)。结论:阴道分娩在产后早期对盆底肌电位及肌力的影响较择期或急诊剖宫产明显。与急诊剖宫产相比,择期剖宫产对盆底肌功能的益处不大。会阴侧切并不能减低阴道分娩对盆底肌功能的影响。Objective:To investigate the effects of different delivery modes on pelvic floor muscle potential and muscle strength of primiparas in early postpartum period.Methods:A prospective study has been conducted on primiparas who received prenatal and postnatal pelvic floor function examination in The First Hospital of Hebei Medical University since September 2018.According to the delivery mode,the primiparas were divided into the vaginal delivery group,emergency cesarean section group and elective cesarean section group,and the vaginal delivery group was subdivided into the perineal lateral resection group and non-perineal lateral resection group.The maximum electromyographic value of pelvic floor muscles,strength and fatigue degree of classⅠandⅡmuscle fibers were quantitatively measured at 36-38 weeks of gestation and 6-8 weeks of postpartum.Results:To August 2019,a total of 221 parturient women were included,139 cases in the vaginal delivery group(61 cases in the perineal resection group and 78 cases in the non-perineal resection group),27 cases in the emergency cesarean section group and 55 cases in the elective cesarean section group.At 36-38 weeks of gestation,the differences of the maximum myopotential,muscle fiber strength and fatigue of pelvic floor muscle among three groups were statistically significant(P>0.05).At postpartum 6-8 weeks,the maximum myopotential,strength and fatigue degree of classⅠandⅡmuscle fibers in vaginal delivery group were lower than those in emergency cesarean section group and selective cesarean section group(P<0.05 to P<0.01).The differences of the maximum myopotential,strength and fatigue degree of classⅠandⅡmuscle fibers between the perineal lateral resection group and non-perineal lateral resection group were not statistically significant(P>0.05).Conclusions:The effects of vaginal delivery on the pelvic floor muscle potential and muscle strength in early postpartum period is more obvious than that of elective or emergency cesarean section.Compared with the emergency ces

关 键 词：分娩方式 初产妇 盆底肌收缩力 盆底功能障碍 

分 类 号：R714[医药卫生—妇产科学]