初产妇经阴道分娩时会阴侧切和自然裂伤对盆底功能障碍的影响

[目的]探讨阴道分娩时会阴侧切和自然裂伤对产妇盆底功能障碍(PFD)的影响.[方法]200例阴道分娩过程中行阴道侧切或发生自然裂伤患者列入研究组；另选取同期本院行剖宫产手术患者200例列入对照组,于产后6～8周,对所有入选产妇行盆底功能指标检测,包括盆腔脏器脱垂(POP)、压力性尿失禁(SUI)和盆底肌力.[结果]研究组PFD发生率为48％,对照组为7.5％；研究组患者POP和SUI发生率明显高于对照组(P＜0.05)；研究组产妇肌电图平均活力值和功值均明显低于对照组(P＜0.05).[结论]阴道分娩对于产妇盆底功能的影响更大,易加大PFD的发生率,虽剖宫产较自然分娩可保护盆底功能,但是否可作为剖宫产的选择依据,仍需要长期和大量的样本试验进行验证.

Clinical Study of Pelvic Floor Dysfunction Caused by Episiotomy and Perineal Natural Lacera-tion of Primiparaea During Vaginal Delivery

[Objective] To explore the effect of episiotomy and perineal natural laceration on pelvic floor dysfunction（PFD） of parturients during vaginal delivery. [Methods] Totally 200 patients undergoing episioto- my or with perineal natural laceration during vaginal delivery were enrolled in the study group. Synchronic 200 patients with cesarean section in our hospital were enrolled in control group. At 6~8 week after delivery, pel- vic floor function indexes including pelvic organ prolapse（POP）, stress incontinence（SUI） and pelvic floor muscle strength of all subjects were examined. [Results] The incidence of PFD in study group and control group were 48 ~ and 7.50~, respectively. The incidence of POP and SUI in study group were obviously higher than those in control group（ P d0.05）. The average vitality value and power value of electromyogram in study group were obviously lower than those in control group（ P d0.05）. [Conclusion] Vaginal delivery has more influence on pelvic floor function of parturients, and is easy to increase the incidence of dysfunction. However cesarean section for protecting the pelvic floor function as the selective evidence of cesarean section should be verified by long-term and large-sample trials.