三种不同分娩方式对产妇产后性功能和盆底功能的影响

目的:探讨阴道分娩、会阴侧切、剖宫产对产妇产后性功能和盆底功能的影响。方法:本研究对象为2014年3月至2015年9月期间于我院妇产科分娩的107例单胎初产妇,根据分娩方式将产妇分为阴道分娩组(n=28)、会阴侧切组(n=37)、剖宫产组(n=42)。对比分析三组产妇产后3个月、6个月及9个月性功能状况、盆底肌力、膀胱颈角度及膀胱颈旋转角度异常发生率,记录产后3个月、6个月及9个月三组产妇性功能障碍发生率和盆底功能障碍性疾病发生率。结果:阴道分娩组和会阴侧切组产妇产后3个月性功能障碍发生率、盆底肌力0~2分比例、盆底功能障碍性各疾病发生率、膀胱颈角度异常及膀胱颈旋转角度异常发生率高于剖宫产组(P0.05);会阴侧切组产后3个月和产后6个月FSFI总分显著低于阴道分娩组和剖宫产组(P0.05);阴道分娩组产后3个月FSFI总分、功能障碍发生率与剖宫产组比较有统计学意义(P0.05);阴道分娩组产妇产后3个月性功能障碍发生率高于剖宫产组(P0.05);剖宫产组产妇产后3个月膀胱颈角度及膀胱颈旋转角度异常发生率显著低于阴道分娩组(P0.05)。结论:会阴侧切对初产妇产后性功能和盆底功能有较大不良影响,剖宫产有助于产妇产后早期性功能和盆底功能的恢复,但长期来看,与阴道分娩相比不具优越性。

Effects of three different modes of delivery on postpartum sexual function and pelvic floor function

Objectives:To investigate the effect of vaginal delivery,perineal side incision and cesarean section on postpartum sexual function and pelvic floor function.Methods The 107 primipara in our hospital from March 2014 to September 2015,according to the mode of delivery,were divided into vaginal delivery group (n =28),episiotomy group (n =37) and cesarean section group (n =42).Comparative analysis was conducted on the sexual function,pelvic muscle and bladder neck angle and the rotation angle of the bladder neck among the three groups at postpartum 3 months,6 months and 9 months,and the incidence of sexual dysfunction and pelvic floor dysfunction were also recorded and compared.Results The incidence of sexual dysfunction,pelvic floor muscle strength 0 ～ 2,pelvic floor dysfunction disease,bladder neck and abnormal bladder neck rotation angle in the vaginal delivery group and episiotomy group postpartum 3 months were higher than those of cesarean section group (P ＜0.05).At postpartum 3 month and 6 months,the postpartum FSFI scores were significantly lower than that in vaginal delivery group and the cesarean section group (P ＜ 0.05).At postpartum 3 months,difference in the FSFI scores and dysfunction rate in vaginal delivery group was statistically significant between episiotomy group and cesarean section group (P ＜ 0.05).At postpartum 3 months,the incidence of sexual dysfunction in vaginal delivery group was higher than the cesarean section group (P ＜ 0.05).;the incidence of abnormal bladder neck rotation angle in the cesarean section group was significantly lower than that in vaginal delivery group (P ＜ 0.05).Conclusion:Episiotomy exerts great adverse effects on the sexual function and pelvic floor function of primipara while cesarean section is conductive to the recovery of postpartum sexual function and pelvic floor function,but in the long term cesarean section is of no advantages.