| 分娩方式及分娩因素对产妇产后早期发生盆腔脏器脱垂的影响 |
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| 引用本文： | 王丽惠,沈小芳,徐亚萍,王璐璐. 分娩方式及分娩因素对产妇产后早期发生盆腔脏器脱垂的影响[J]. 中华全科医学, 2019, 17(9): 1530-1532. DOI: 10.16766/j.cnki.issn.1674-4152.000989 |
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| 作者姓名： | 王丽惠 沈小芳 徐亚萍 王璐璐 |
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| 作者单位： | 浙江省中西医结合医院妇产科, 浙江 杭州 310003 |
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| 基金项目： | 浙江省中医药科技计划项目(2018ZA093) |
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| 摘 要： | 目的 观察不同分娩方式对产妇产后早期发生盆腔脏器脱垂的影响，分析产科分娩因素与早期发生盆腔脏器脱垂的关联性。 方法 选取2017年1—12月在浙江省中西医结合医院分娩的489例孕产妇作为研究对象，按照分娩方式的不同，将产妇分为阴道分娩组245例和剖宫产组244例，采用χ2检验分析不同分娩方式对产妇早期发生盆腔脏器脱垂的影响，采用χ2检验、logistic回归分析对产科分娩因素(常见的分娩因素有年龄、BMI、产次、孕次、新生儿性别、孕期增加体重、分娩孕周、胎儿体重等)与产妇早期发生盆腔脏器脱垂的关联性进行分析。 结果 489例产妇有79例早期发生盆腔脏器脱垂，发生率为16.16%，阴道分娩产妇盆腔脏器脱垂的发生率为22.86%，高于剖宫产的9.43%，阴道分娩组发生阴道前壁脱垂、阴道后壁脱垂、子宫脱垂的例数明显高于剖宫产组(P<0.05)；经χ2检验和logistic回归分析得出，年龄、新生儿性别、孕期增加体重对产妇产后早期发生盆腔脏器脱垂没有影响，BMI≥24 kg/m2、产次>2、怀孕次数>2、分娩孕周≥37周、胎儿体重≥4 kg为影响产妇产后早期发生盆腔脏器脱垂的危险因素。 结论 不同分娩方式、产妇BMI、产次、孕次、分娩孕周以及胎儿体重对产妇产后盆腔脏器脱垂的发生率有较大的影响，临床上应该建议产妇重视BMI指标、产次、孕次、分娩孕周和胎儿体重，孕期不要过分摄入营养造成胎儿过大，以降低产妇产后发生盆腔脏器脱垂的概率。
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| 关 键 词： | 分娩方式 盆腔脏器脱垂 分娩因素 logistic回归分析 |
| 收稿时间： | 2019-01-06 |
The effect of different delivery methods on pelvic organ prolapse in early postpartum period and the correlation between obstetric delivery factors and early pelvic organ prolapse |
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| Affiliation: | Department of Obstetrics and Gynecology, Zhejiang Integrated Traditional Chinese and Western Medicine Hospital， Hangzhou, Zhejiang 310003, China |
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| Abstract: | Objective To observe effect of different delivery methods on pelvic organ prolapse in early postpartum period and the correlation between obstetric delivery factors and early pelvic organ prolapse. Methods A total of 489 pregnant women who gave birth in our hospital from January to December in 2017 were selected as subjects. According to the different delivery methods, 245 women were divided into vaginal delivery group and 244 cases in cesarean section. The χ2 test was used to analyze different delivery methods. The effect of pelvic organ prolapse in early maternal gynecology, and the use of χ2 test, logistic regression analysis of obstetric delivery factors (common birth factors include age, BMI, parity, pregnancy, neonatal gender, weight gain during pregnancy, gestational weeks of delivery, fetal weight, and the early maternal pelvic organ prolapse, etc.). Results There were 79 cases of early pelvic organ prolapse in 489 cases, the incidence rate was 16.16%, the incidence of pelvic organ prolapse in vaginal delivery was 22.86%, which was higher than 9.43% of cesarean section. According to the χ2 test, the number of vaginal prolapse, vaginal posterior wall prolapse, and uterine prolapse in the vaginal delivery group was significantly higher than that in the cesarean section (P<0.05). Test and logistic regression analysis showed that age, neonatal gender, and increased body weight during pregnancy had no effect on pelvic organ prolapse in early postpartum period, BMI≥24 kg/m2, birth>2, number of pregnancies>2, gestational weeks ≥37 weeks, fetal weight≥4 kg are among risk factors affecting pelvic organ prolapse in the early postpartum period. Conclusion Different modes of delivery, maternal BMI, parity, pregnancy, gestational weeks and fetal weight have a greater impact on the incidence of postpartum pelvic organ prolapse. In clinical practice, it is recommended that women pay attention to BMI, parity, and pregnancy. Second, delivery gestational age and fetal weight, without excessive intake of nutrition during pregnancy to cause oversized fetus, in order to reduce the probability of pelvic organ prolapse after maternal postpartum. |
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