摘要
目的分析不同分娩方式对产后压力性尿失禁(SUI)的影响。方法选取2022年1月至2023年6月在淄博市妇幼保健院建档并定期体检的初产妇392例,按照分娩方式不同分组,阴道分娩组220例,剖宫产172例。对两组产妇进行产后3个月盆底肌功能测定及SUI的追踪调查,对比分析相关数据,为SUI的早期干预提供参考。结果阴道分娩组尿失禁发生率23.64%高于对照组15.12%,且在轻度发生率10.45%、4.65%上的差异有统计学意义(均P<0.05)。阴道分娩组MFR、PVR高于剖宫产组(均P<0.001);阴道分娩组盆底肌肌力1级比例9.09%高于剖宫产组6.98%,5级比例27.27%低于剖宫产组37.21%(均P<0.05);其他分级对比差异无统计学意义(P>0.05);阴道分娩组BND低于剖宫产组,安静状态下肛提肌裂孔面积、最大Valsalv动作下肛提肌裂孔面积大于剖宫产组(均P<0.001)。结论阴道分娩产妇发生产后SUI的比例高,排尿功能较剖宫产产妇更差,盆底肌肌力水平更低,盆底组织松弛的情况更明显,提示相对于剖宫产产妇,阴道分娩的产妇更应在产后3个月内实施积极的临床干预。
Objective To analyze the impact of different delivery methods on postpartum stress urinary incontinence(SUI).Methods A total of 392 primiparous women who were registered and underwent regular physical examinations in Zibo Maternal and Child Health Hospital from January 2022 to June 2023 were selected.They were divided into different groups according to delivery methods,with 220 cases in the vaginal delivery group and 172 cases in the cesarean section group.Conduct pelvic floor muscle function testing and follow-up investigation on stress urinary incontinence in two groups of postpartum women at 3 months,compare and analyze relevant data,and provide reference for early intervention of SUI.Results The incidence of urinary incontinence in the vaginal delivery group was 23.64%higher than that in the control group,which was 15.12%.The difference in mild incidence rates was statistically significant at 10.45%and 4.65%(all P<0.05).The MFR and PVR in the vaginal delivery group were higher than those in the cesarean section group(all P<0.001).The proportion of pelvic floor muscle strength grade 1 in the vaginal delivery group was 9.09%higher than 6.98%in the cesarean section group,and the proportion of grade 5 was 27.27%lower than 37.21%in the cesarean section group(all P<0.05).There was no significant difference in other grading comparisons(P>0.05).The BND of the vaginal delivery group was lower than that of the cesarean section group.The area of the anal sphincter hiatus in the resting state and the area of the anal sphincter hiatus under maximum Valsalv action was larger than that of the cesarean section group(all P<0.001).Conclusions Women who give birth vaginally have a higher proportion of postpartum SUI,poorer urinary function,lower pelvic floor muscle strength,and more pronounced pelvic floor tissue relaxation compared to those who give birth by cesarean section.This suggests that compared to those who give birth by cesarean section,women who give birth vaginally should implement active clinical interventions within 3 months after delivery.
作者
曹长梅
李华伟
姜云霞
CAO Changmei;LI Huawei;JIANG Yunxia(School of Nursing,Qingdao University,Qingdao,Shandong 266000,China;Department of Obstetrics and Gynecology,Zibo Maternal and Child Health Hospital,Zibo,Shandong 255100,China)
出处
《中国医药指南》
2025年第6期46-48,共3页
Guide of China Medicine
关键词
产后压力性尿失禁
剖宫产
阴道分娩
盆底肌功能
Postpartum stress urinary incontinence
Cesarean section
Vaginal delivery
Pelvic floor muscle function
