顺产、剖宫产及产钳助产对初产妇产后盆底状态及性功能的影响比较
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摘要
目的观察与比较顺产、剖宫产及产钳助产对初产妇产后盆底状态及性功能的影响程度。方法选取2016年2月至2017年3月成都市第五人民医院接收的52例顺产初产妇为A组,同期的52例剖宫产产妇为B组,52例产钳助产产妇为C组。比较三组产妇产后8周、16周及24周的盆底肌力、尿流动力学及BISF-W量表结果。结果产后8周及16周B组的盆底肌力、尿流动力学及BISF-W量表结果均好于A组及C组,差异具有统计学意义(P <0. 05),产后24周三组的盆底肌力、尿流动力学及BISF-W量表结果比较,差异无统计学意义(P> 0. 05),产后8周及16周A组与C组的盆底肌力、尿流动力学及BISF-W量表结果比较,差异无统计学意义(P> 0. 05)。结论顺产、剖宫产及产钳助产对初产妇产后盆底状态及性功能的影响较大,剖宫产早期评估状态较好,后期与顺产及产钳助产的差异不明显。
Objective To observe and compare the influence degree of vaginal delivery,cesarean section and forceps delivery on the postpartum pelvic floor state and sexual function of primiparas. Methods 52 primiparas adopted vaginal delivery in Chengdu the 5~(th) people's Hospital from February 2016 to March 2017 were selected as group A; 52 primiparas adopted cesarean section at the same period were selected as group B and 52 primiparasadopted forceps delivery were selected as group C. The pelvic floor muscle strength,urine flow dynamics and BISFW scale of the three groups at the 8~(th),16~(th) and 24~(th) week after delivery was compared. Results The results of pelvic floor muscle strength,urine flow dynamics and BISF-W scale of group B at the 8~(th) and 16 thweek after delivery were all better than those of group A and group C,with statistically significant differences( P < 0. 05). The results of pelvic floor muscle strength,urine flow dynamics and BISF-W scale of three groups at the 24 thweek after delivery were compared,and there was no statistically significant difference( P > 0. 05). The results of pelvic floor muscle strength,urine flow dynamics and BISF-W scale of group A and group C at the 8~(th) and 16~(th) week after delivery were compared,and there was no statistically significant difference( P > 0. 05). Conclusions The vaginal delivery,cesarean section and forceps delivery is of large effect on the postpartum pelvic floor state and sexual function of primiparas. The cesarean section has better early evaluation state,while no significant difference is found later among the three delivery methods.
Objective To observe and compare the influence degree of vaginal delivery,cesarean section and forceps delivery on the postpartum pelvic floor state and sexual function of primiparas. Methods 52 primiparas adopted vaginal delivery in Chengdu the 5~(th) people's Hospital from February 2016 to March 2017 were selected as group A; 52 primiparas adopted cesarean section at the same period were selected as group B and 52 primiparasadopted forceps delivery were selected as group C. The pelvic floor muscle strength,urine flow dynamics and BISFW scale of the three groups at the 8~(th),16~(th) and 24~(th) week after delivery was compared. Results The results of pelvic floor muscle strength,urine flow dynamics and BISF-W scale of group B at the 8~(th) and 16 thweek after delivery were all better than those of group A and group C,with statistically significant differences( P < 0. 05). The results of pelvic floor muscle strength,urine flow dynamics and BISF-W scale of three groups at the 24 thweek after delivery were compared,and there was no statistically significant difference( P > 0. 05). The results of pelvic floor muscle strength,urine flow dynamics and BISF-W scale of group A and group C at the 8~(th) and 16~(th) week after delivery were compared,and there was no statistically significant difference( P > 0. 05). Conclusions The vaginal delivery,cesarean section and forceps delivery is of large effect on the postpartum pelvic floor state and sexual function of primiparas. The cesarean section has better early evaluation state,while no significant difference is found later among the three delivery methods.
引文
[1]曹莹,张庆华,吴丽霞. 3种分娩方式对高龄初产妇产后早期抑郁和盆底肌力的影响[J].中国妇幼保健,2015,30(24):4135-4137.
[2]黄娟.剖宫产术对孕妇产后盆底功能及性功能的影响研究[J].现代诊断与治疗,2017,28(8):1504-1505.
[3]张珂,王澜静,焦玲洁,等.产后盆底功能障碍性疾病与盆底肌收缩力及其相关因素分析[J].实用妇产科杂志,2014,30(10):757-759.
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[7]栾琳,杨俊卿.妊娠和分娩过程中不同因素对产后早期盆底功能的影响[J].影像研究与医学应用,2017(2):232-233.
[8]陈钊,杜琳.顺产孕妇产后早期盆底功能恢复情况观察.中国卫生标准管理,2015,6(15):82-84.
[9] Silva VR,Riccetto CL,Martinho NM,et al. Training through gametherapy promotes coactivation of the pelvic floor and abdominal muscles in young women,nulliparous and continents[J]. Int Braz J Urol,2016,42(4):779-786.
[10] Hagen S,Glazener C,Mc Clurg D,et al. Pelvic floor muscle training for secondary prevention of pelvic organ prolapse(PREVPROL):A multicentre randomised controlled trial[J]. Lancet,2017,389(10067):393-402.
[11]龚天柳.不同分娩方式对产后妇女盆底功能影响的临床分析[J].中国临床新医学,2015,8(7):633-636.
[12]高雯,吕凤君,张翠萍,等.天津地区产后盆底肌力损伤的相关因素分析[J].天津医药,2015,43(7):800-803.
[13]李肇英,倪茂杰,金静,等.经会阴超声在阴道分娩初产妇产后早期盆底功能评估中的应用[J].临床超声医学杂志,2016,18(8):565-566.
[14]刘娟,陈灿明,徐扬.产后早期盆底功能障碍性疾病患者的盆底肌力影响因素分析[J].中国妇幼卫生杂志,2015,6(5):9-12.
[15] Tennfjord MK,Engh ME,BK. An intra-and interrater reliability and agreement study of vaginal resting pressure,pelvic floor muscle strength,and muscular endurance using a manometer[J]. Int Urogynecol J,2017,28(10):1507-1514.
[16]李利波,李洪双,梁梅珍.产后盆底功能障碍性疾病与盆底肌收缩力的关系及相关因素分析[J].中国医学工程,2015,23(6):44-45.
[17]井跃华.剖宫产和阴道分娩方式的选择对产后盆底肌力恢复的影响[J].实用妇科内分泌杂志(电子版),2017,4(3):27,30.
[18]雷桂梅,王姝,樊兰娟.不同分娩方式对产后早期盆底功能障碍影响及康复治疗效果的研究[J].中国农村卫生事业管理,2017,37(6):704-705.
[2]黄娟.剖宫产术对孕妇产后盆底功能及性功能的影响研究[J].现代诊断与治疗,2017,28(8):1504-1505.
[3]张珂,王澜静,焦玲洁,等.产后盆底功能障碍性疾病与盆底肌收缩力及其相关因素分析[J].实用妇产科杂志,2014,30(10):757-759.
[4]卢潭敏.女性产后盆底功能与分娩相关因素的分析[J].中国妇幼保健,2015,30(14):2240-2242.
[5]史红霞.不同分娩方式对产后盆底功能影响及康复治疗的效果分析[J].实用医技杂志,2017,24(1):94-95.
[6] Ghandour L,Minassian V,Al-Badr A,et al. Prevalence and degree of bother of pelvic floor disorder symptoms among women from primary care and specialty clinics in Lebanon:An exploratory study[J]. Int Urogynecol J,2017,28(1):105-118.
[7]栾琳,杨俊卿.妊娠和分娩过程中不同因素对产后早期盆底功能的影响[J].影像研究与医学应用,2017(2):232-233.
[8]陈钊,杜琳.顺产孕妇产后早期盆底功能恢复情况观察.中国卫生标准管理,2015,6(15):82-84.
[9] Silva VR,Riccetto CL,Martinho NM,et al. Training through gametherapy promotes coactivation of the pelvic floor and abdominal muscles in young women,nulliparous and continents[J]. Int Braz J Urol,2016,42(4):779-786.
[10] Hagen S,Glazener C,Mc Clurg D,et al. Pelvic floor muscle training for secondary prevention of pelvic organ prolapse(PREVPROL):A multicentre randomised controlled trial[J]. Lancet,2017,389(10067):393-402.
[11]龚天柳.不同分娩方式对产后妇女盆底功能影响的临床分析[J].中国临床新医学,2015,8(7):633-636.
[12]高雯,吕凤君,张翠萍,等.天津地区产后盆底肌力损伤的相关因素分析[J].天津医药,2015,43(7):800-803.
[13]李肇英,倪茂杰,金静,等.经会阴超声在阴道分娩初产妇产后早期盆底功能评估中的应用[J].临床超声医学杂志,2016,18(8):565-566.
[14]刘娟,陈灿明,徐扬.产后早期盆底功能障碍性疾病患者的盆底肌力影响因素分析[J].中国妇幼卫生杂志,2015,6(5):9-12.
[15] Tennfjord MK,Engh ME,BK. An intra-and interrater reliability and agreement study of vaginal resting pressure,pelvic floor muscle strength,and muscular endurance using a manometer[J]. Int Urogynecol J,2017,28(10):1507-1514.
[16]李利波,李洪双,梁梅珍.产后盆底功能障碍性疾病与盆底肌收缩力的关系及相关因素分析[J].中国医学工程,2015,23(6):44-45.
[17]井跃华.剖宫产和阴道分娩方式的选择对产后盆底肌力恢复的影响[J].实用妇科内分泌杂志(电子版),2017,4(3):27,30.
[18]雷桂梅,王姝,樊兰娟.不同分娩方式对产后早期盆底功能障碍影响及康复治疗效果的研究[J].中国农村卫生事业管理,2017,37(6):704-705.
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