[1]欧阳丽萍,孟召然,李 玲,等.盆底肌力联合盆底超声评估分娩方式对产后早期盆底功能的影响[J].医学信息,2019,(10):95-98.[doi:10.3969/j.issn.1006-1959.2019.10.030]
 OUYANG Li-ping,MENG Zhao-ran,LI Ling,et al.Effect of Pelvic Floor Muscle Strength Combined with Pelvic Floor Ultrasound on the Function of Delivery Mode in Early Postpartum Pelvic Floor Function[J].Medical Information,2019,(10):95-98.[doi:10.3969/j.issn.1006-1959.2019.10.030]
点击复制

盆底肌力联合盆底超声评估分娩方式对产后早期盆底功能的影响()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期数:
2019年10期
页码:
95-98
栏目:
论著
出版日期:
2019-05-15

文章信息/Info

Title:
Effect of Pelvic Floor Muscle Strength Combined with Pelvic Floor Ultrasound on the Function of Delivery Mode in Early Postpartum Pelvic Floor Function
文章编号:
1006-1959(2019)10-0095-04
作者:
欧阳丽萍孟召然李 玲范建辉
(中山大学附属第三医院产科,广东 广州 510630)
Author(s):
OUYANG Li-ping MENG Zhao-ranLI LingFAN Jian-hui
(Department of Obstetrics,Third Affiliated Hospital,Sun Yat-sen University,Guangzhou 510630,Guangdong,China)
关键词:
分娩方式盆底肌力盆底超声
Keywords:
Mode of deliveryPelvic floor muscle strengthPelvic floor ultrasound
分类号:
R714.6;R445.1
DOI:
10.3969/j.issn.1006-1959.2019.10.030
文献标志码:
A
摘要:
目的 探讨不同分娩方式对产后早期盆底解剖结构和功能的影响。方法 收集2015年4月~2016年7月在中山大学附属第三医院岭南医院分娩,并在产后6~12周复查的产妇共469例,按照分娩方式分为会阴侧切组187例、会阴裂伤组195例和选择性剖宫产组87例。应用盆底肌电生理仪和3D会阴超声两种评价方式评估三组产妇产后产后盆底Ⅰ类Ⅱ类肌纤维肌力异常率、膀胱颈位置、膀胱移动度、Valsalva动作后肛提肌裂孔面积、膀胱后角的开放率及尿道内口漏斗形成率差异。结果 产后盆底Ⅰ类和Ⅱ类肌纤维肌力的异常率分别为85.92%,84.86%,其中裂伤组的异常率89.74%,88.21%,高于剖宫产组的78.16%,74.71%,差异有统计学意义(P<0.05)。其余组间比较,差异无统计学意义(P>0.05);三组间静息状态下膀胱颈的位置比较,差异无统计学意义(P>0.05);裂伤组及侧切组的膀胱移动度及Valsalva动作后肛提肌裂孔面积大于剖宫产组,差异有统计学意义(P<0.05),而侧切组与裂伤组比较,差异无统计学意义(P>0.05);侧切组及裂伤组的膀胱后角的开放率及尿道内口漏斗形成率高于剖宫产组,差异有统计学意义(P<0.05),侧切组与裂伤组比较,差异无统计学意义(P>0.05)。结论 选择性剖宫产对盆底功能有一定的保护作用。阴道分娩的女性产后盆底组织结构变化较选择性剖宫产的更明显,会阴侧切对产后早期盆底的结构及功能影响无明显差异。
Abstract:
Objective To investigate the effects of different modes of delivery on the anatomical structure and function of the pelvic floor in the early postpartum period.Methods A total of 469 maternal women who were delivered at Lingnan Hospital of the Third Affiliated Hospital of Sun Yat-sen University from April 2015 to July 2016 and who were reviewed 6 to 12 weeks after delivery were divided into 187 cases of perineal side-cutting group and perineal laceration according to the mode of delivery. There were 195 patients in the group and 87 patients in the elective cesarean section. The pelvic floor electrophysiology instrument and 3D perineal ultrasound evaluation were used to evaluate the abnormal rate of postpartum pelvic floor I type II muscle fiber muscle strength, bladder neck position, bladder mobility, levator ani muscle area after Valsalva movement. The open rate of the posterior horn of the bladder and the difference in the formation rate of the funnel in the urethra. Results The abnormal rates of postpartum pelvic floor I and II muscle fiber muscle strength were 85.92%, 84.86%,The abnormal rate of laceration group was 89.74%,88.21% higher than that of cesarean section group,78.16%,74.71%,the difference was statistically significant(P<0.05).There was no significant difference between the other groups(P>0.05). There was no significant difference in the position of bladder neck between the three groups(P>0.05). The bladder mobility of the laceration group and the lateral cut group After Valsalva's action, the area of the levator ani muscle was larger than that of the cesarean section, the difference was statistically significant (P<0.05), but the difference between the side cut group and the laceration group was not statistically significant (P>0.05);The open rate of the posterior ventral horn and the formation rate of the urethral funnel in the lateral cut group and the laceration group were higher than those in the cesarean section,the difference was statistically significant (P<0.05). There was no significant difference between the lateral cut group and the laceration group (P>0.05).Conclusion Selective cesarean section has a certain protective effect on pelvic floor function. The changes of postpartum pelvic tissue structure in women with vaginal delivery were more obvious than those of selective cesarean section. There was no significant difference in the structure and function of pelvic floor in the early postpartum period.

参考文献/References:

[1]Walker GJ,Gunasekera P.Pelvic organ prolapse and incontinence in developing countries:review of prevalence and risk factors[J].Int Urogynecol J,2011,22(2):127-135.
[2]van der Walt I,Bo K,Hanekom S,et al.Ethnic differences in pelvic floor muscle strength and endurance in South African women[J].Int Urogynecol J,2014,25(6):799-805.
[3]Kokabi R,Yazdanpanah D.Effects of delivery mode and sociodemographic factors on postpartum stress urinary incontinency in primipara women: A prospective cohort study[J].J Chin Med Assoc,2017,80(8):498-502.
[4]Bozkurt M,Yumru AE,Sahin L.Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor[J].Taiwan J Obstet Gynecol,2014,53(4):452-458.
[5]Gyhagen M,Bullarbo M,Nielsen TF,et al.Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth:a national cohort study in singleton primiparae after vaginal or caesarean delivery[J].Bjog An International Journal of Obstetrics & Gynaecology,2013,120(2):152-160.
[6]刘芬,陈敦金.妊娠及分娩对盆底肌力的影响[J].热带医学杂志,2012(2):148-150.
[7]李淑萍,李婕娜,王英红.盆底超声检查和盆底肌力评估分析不同分娩方式对女性盆底功能的影响[J]. 中国妇幼保健,2014,29(21):3520-3522.
[8]孙智晶,朱兰,郎景和,等.初产妇产后6周盆底电生理指标及盆腔器官脱垂分度状况全国多中心横断面研究[J].中国实用妇科与产科杂志,2015(5):433-439.
[9]Dietz HP,Hoyte LPJ,Steensma AB.Atlas of Pelvic Floor Ultrasound[M].Springer,2008.
[10]李金英,黄志,刘桃,等.经会阴盆底四维超声评估产后妇女盆隔裂孔影像特征的应用[J].中国妇幼健康研究,2016(9):1101-1104.
[11]Glazener C,Elders A,Macarthur C,et al.Childbirth and prolapse: long-term associations with the symptoms and objective measurement of pelvic organ prolapse[J].BJOG,2013,120(2):161-168.
[12]Liu F,Xu L,Ying T,et al.Three-dimensional ultrasound appearance of pelvic floor in nulliparous women and postpartum women one week after their first delivery[J].Int J Med Sci, 2014,11(3):234-239.

相似文献/References:

[1]张秀华,徐 凡,吴 琴,等.川东北地区剖宫产再孕妇女分娩方式的选择对 助产士岗位需求影响的研究[J].医学信息,2018,(16):101.[doi:10.3969/j.issn.1006-1959.2018.16.030]
 ZHANG Xiu-hua,XU Fan,WU Qin,et al.Study on the Influence of the Choice of Delivery Mode on the Demand of Midwives in Re-pregnant Women Underwent Cesarean Section in Northeastern Sichuan[J].Medical Information,2018,(10):101.[doi:10.3969/j.issn.1006-1959.2018.16.030]
[2]吴 琴,祝 艳,徐 凡,等.二胎政策下基于产妇分娩方式的选择对助产士岗位能力需求的研究[J].医学信息,2019,(07):143.[doi:10.3969/j.issn.1006-1959.2019.07.043]
 WU Qin,ZHU Yan,XU Fan,et al.Study on the Needs of Midwives' Post Competency Based On The Choice of Maternal Delivery Mode Under the Second Child Policy[J].Medical Information,2019,(10):143.[doi:10.3969/j.issn.1006-1959.2019.07.043]

更新日期/Last Update: 2019-05-15