不同分娩方式对产后早期盆底肌力影响的研究

目的:探讨不同分娩方式对产后早期盆底功能的影响。方法:随机选择2008年9～11月妇保科产后门诊6～8周复查的产妇58例,按不同分娩方式分为选择性剖宫产组(26例)和阴道顺产组(32例)。同期40例健康体检已婚未产妇女做对照,采用盆底肌力检测法进行评价盆底肌力,按0～5分进行对比研究。结果:产后6～8周盆底肌力检测择期剖宫产组≤3分19%(5/26),≥4分81%(21/26);阴道分娩组≤3分50%(16/32),≥4分50%(16/32);两组比较差异均有统计学意义(P<0.05)。结论:两种分娩方式对产后早期盆底肌力均有影响,相对于阴道分娩剖宫产可能在一定程度上降低了对盆底肌力的影响,但采取选择性剖宫产终止妊娠不是最佳解决办法。建议所有经过妊娠和分娩的妇女均应在产后及早做盆底功能的恢复训练,以降低女性盆底功能障碍性疾病(PFD)发生率,或延缓其发病年龄。

Effect of different delivery methods on the pelvic floor muscle strength in the early postpartum

Objective:To explore the effect of different delivery methods on the pelvic floor muscle strength in the early postpartum.Methods:From September to November in 2008,58 women after delivered 6~8 weeks were selected and divided into two groups according to different delivery methods,one was selective cesarean section delivery group(26 cases) and the other was vaginal natural delivery group(32 cases);40 healthy married women without birth in the same period was control group.Pelvic floor muscle strength testing method was used to evaluate pelvic floor muscle strength according to the comparative study carried out at 0~5.Results:The scores of floor muscle strength testing ≤3 in selective cesarean section group was 19%(5/26),≥4 was 81%(21/26);the scores of floor muscle strength testing ≤3 in vaginal delivery group was 50%(16/32),≥4 was 50%(16/32).There was significant difference between two groups(P<0.05).Conclusion:Two delivery methods both impact on early postpartum pelvic floor muscle strength,cesarean section may reduce the impact of pelvic floor muscle strength at a certain extent compared with vaginal delivery,but selective cesarean section is not the best solution to terminate pregnancy;all the women after pregnancy and delivery should do the pelvic floor function recovery training as soon as possible,in order to reduce the female pelvic floor dysfunction disease(PFD) incidence,or delay its onset age.