摘要
目的探讨基于超声监测下不同分娩方式对产后盆腔盆底结构及盆底肌力修复的意义。方法选取2021年3月至2023年3月在青岛市胶州中心医院分娩的168例初产妇为研究对象,其中阴道分娩的98例纳入阴道分娩组、阴道助产的32例纳入阴道助产组,剖宫产的38例纳入剖宫产组。三组均进行产后康复治疗,分别在治疗前及治疗6周后进行盆底超声检查及盆底肌力检查,比较三组超声指标【用力向下屏气的Valsalva动作下、静息状态下的膀胱尿道后角(PUA)、尿道倾斜角(UTA)、膀胱颈位置(BNP)】、盆底肌力【Ⅰ类肌持续收缩力、Ⅱ类肌最大收缩力】。结果治疗前及康复治疗6周后,用力向下屏气的Valsalva动作下,阴道助产组的PUA、UTA、BNP>阴道分娩组>剖宫产组(P<0.05),且剖宫产组上述3个指标治疗前后的差值>阴道分娩组和阴道助产组(P<0.05);静息状态下,阴道助产组的PUA、UTA>阴道分娩组>剖宫产组(P<0.05),阴道助产组的BNP<阴道分娩组<剖宫产组(P<0.05),且剖宫产组上述3个指标治疗前后的差值>阴道分娩组和阴道助产组(P<0.05);阴道助产组的Ⅰ类肌持续收缩力、Ⅱ类肌最大收缩力均<阴道分娩组<剖宫产组(P<0.05),且剖宫产组上述2个指标治疗前后的差值>阴道分娩组及阴道助产组(P<0.05)。结论不同分娩方式的产妇产后均存在盆腔结构改变及盆底肌力下降,其中阴道助产对其影响最大,阴道分娩居中,剖宫产最小,且剖宫产产妇产后盆底修复速度较经阴道分娩产妇的产后修复速度快。
Objective To explore the significance of different delivery modes based on ultrasound monitoring on the postpartum pelvic floor structure and pelvic floor muscle strength repair.Methods A total of 168 primiparas who gave birth in Jiaozhou Central Hospital of Qingdao from March 2021 to March 2023 were selected as research subjects.Among the patients,98 cases with vaginal delivery were included in vaginal delivery group,32 cases undergoing vaginal midwifery were enrolled as vaginal midwifery group,and 38 cases with cesarean section were assigned as cesarean section group.All the three groups received postpartum rehabilitation treatment.Pelvic floor ultrasound examination and pelvic floor muscle strength examination were performed before treatment and after 6 weeks of treatment.The ultrasound indicators[posterior vesicourethral angle(PUA),urethral tilt angle(UTA)and bladder neck position(BNP)under valsalva motion of holding the breath downward and the resting state]and pelvic floor muscle strength(typeⅠmuscle continuous contraction force,typeⅡmuscle maximum contraction force)were compared among the three groups.Results Under the Valsalva motion of holding the breath downward,the PUA,UTA and BNP before treatment and after 6 weeks of rehabilitation treatment were expressed as vaginal midwifery group>vaginal delivery group>cesarean section group(P<0.05),and the differences of the above indicators before and after treatment were shown as cesarean section group>vaginal delivery group and vaginal midwifery group(P<0.05).Under the resting state,the PUA and UTA showed vaginal midwifery group>vaginal delivery group>cesarean section group(P<0.05)while the BNP was shown as vaginal midwifery group<vaginal delivery group<cesarean section group(P<0.05),and the differences of the above three indicators before and after treatment indicated that cesarean section group>vaginal delivery group and vaginal midwifery group(P<0.05).The typeⅠmuscle continuous contraction force and typeⅡmuscle maximum contraction force were manifested as vaginal midwifery group<vaginal delivery group<cesarean section group(P<0.05),and the differences of the above two indicators before and after treatment were shown as cesarean section group>vaginal delivery group and vaginal midwifery group(P<0.05).Conclusions There are pelvic structural changes and decreased pelvic floor muscle strength in postpartum women with different delivery modes,and vaginal midwifery has the greatest effect,followed by vaginal delivery and cesarean section.The postpartum pelvic floor repair speed of puerperae with cesarean section is faster than that in vaginal delivery.
作者
王占晖
高爱梅
周赵
刘素霞
WANG Zhanhui;GAO Aimei;ZHOU Zhao;LIU Suxia(Department of Health Management,Jiaozhou Central Hospital of Qingdao,Jiaozhou Qingdao Shandong 266300,China;Department of Obstetrics,Jiaozhou Central Hospital of Qingdao,Jiaozhou Qingdao Shandong 266300,China;Department of Special Examination,Jiaozhou Central Hospital of Qingdao,Jiaozhou Qingdao Shandong 266300,China)
出处
《中国妇产科临床杂志》
CSCD
北大核心
2024年第3期233-236,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
青岛市医疗卫生重点学科专项资助(青卫政字[2022]6号)。
关键词
分娩方式
超声监测
盆底结构
盆底肌力
delivery modes
ultrasound monitoring
pelvic floor structure
pelvic floor muscle strength
