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目的探讨不同分娩方式及产科相关因素对盆底支持组织功能的近期影响。方法选取健康初产妇120例,其中阴道分娩72例(阴道分娩组),选择性剖宫产48例(剖宫产组),于分娩后6至8周间进行尿失禁问卷调查、盆底肌电图测定盆底肌肉收缩及舒张功能,并行相关性分析。结果阴道分娩组与剖宫产组产妇分娩后 SUI 的发生率分别为21%(15/72)、10%(5/48)。阴道分娩组盆底肌电图右侧活力值、功值分别为12.9+0.8和59±5,左右两侧平均功值为78±5;剖宫产组右侧活力值、功值分别为17.3±1.7和95±17,左右两侧平均功值109±15,两组各项值比较,差异均有统计学意义(P<0.05)。产妇的年龄(P<0.01)、分娩前体重指数(P<0.01)、新生儿出生体重(P<0.01)及第二产程时间(P=0.003)是产后发生 SUI 的高危因素;年龄、分娩前后体重指数差、第一产程时间、会阴侧切口长度和角度对盆底肌电图的部分测量值有影响。结论阴道分娩后 SUI 发生率与选择性剖官产相似;产科相关因素可以影响产后尿失禁的发生率及盆底肌肉收缩及舒张功能。
Objective To explore the different effects of different modes of delivery and obstetric related factors on the function of pelvic floor supporting tissues. Methods 120 healthy primiparous women were selected, including 72 vaginal deliveries (vaginal delivery group), 48 selective cesarean section (cesarean delivery group), urinary incontinence questionnaire between 6 and 8 weeks after childbirth, pelvic floor muscle Electrical map of pelvic floor muscle contraction and diastolic function, parallel correlation analysis. Results The incidences of SUI after vaginal delivery and cesarean delivery were 21% (15/72) and 10% (5/48), respectively. Vagina delivery group pelvic floor EMG right vitality, power values were 12.9 +0.8 and 59 ± 5, left and right average work value of 78 ± 5; cesarean section group on the right vitality, power values were 17.3 ± 1.7 and 95 ± 17, and the average power value of the left and right sides was 109 ± 15. The differences between the two groups were statistically significant (P <0.05). The age at delivery (P <0.01), body mass index before delivery (P <0.01), birth weight (P <0.01) and second stage of labor (P = 0.003) Body mass index difference, the first stage of labor time, episiotomy side incision length and angle of the pelvic floor EMG part of the measured value. Conclusions The incidence of SUI after vaginal delivery is similar to that of selective censorship. Obstetric related factors may influence the incidence of postpartum urinary incontinence and pelvic floor contractility and diastolic function.