产后盆底肌力情况及影响因素分析

目的 评估产后女性盆底肌力的状态,分析影响产后女性盆底肌力评级的因素.方法 以2014年3月至2016年2月在南京军区福州总医院接受盆底肌力检测的产后女性共2188例作为研究对象,利用PHENIX 2诊断系统平台,结合评价盆底肌肉综合肌力的指标Oxford评分(MOS)对盆底不同类别的肌纤维进行肌力评级,并对影响肌力评级的相关因素进行相关统计学分析.结果 ①PHENIX评估和MOS评分对盆底肌力的评定无显著差异(P＞0.05).②近4/5的产后女性盆底肌力的异常.③孕前体重越大及孕前BMI越小,盆底Ⅰ类肌异常的风险越大;而产后体重越小及产后BMI越大,盆底Ⅰ类肌的风险越大.④顺产、孕周和产次的增加,都可导致盆底Ⅱ类肌纤维肌力异常的风险增加.⑤选择适当的会阴切开方式(胎头位置、长度、角度)在短时间内不会影响盆底肌纤维肌力.⑥在42～60 d的研究范围内,年龄、身高、胎儿体重不是影响盆底肌力的相关因素.结论 妊娠及分娩是影响产后女性盆底肌力的重要因素,通过对产后盆底肌力情况及影响因素进行分析,对女性盆底肌功能障碍的防治具有指导意义.

The correlation analysis of the female pelvic floor muscle strength andinfluencing factors of pelvic floor muscle strength disorder

Objective To evaluate the status of women`s pelvic floor muscle(PFM)strength and analysis influencing factors of PFM strength during postpartum period.Methods There are included 2188 postpartum women who received PFM testing in Fuzhou General Hospital of Nanjing Military Region.The different muscle fibers of PFM strength was detected by PHENIX 2 diagnostic system and modified Oxford scale(MOS).Simultaneously,the influencing factors were analysed by statistical methods.Results ①There was no significant difference in pelvic floor muscle strength between PHENIX evaluation and MOS score.② Nearly 4/5 postpartum women suffered from pelvic floor muscle disorder.③ The people will bear more risk in type Ⅰ pelvic floor muscle fibers disorder who have more weight and lower BMI before pregnancy,and lower weight and more BMI after birth.④ Type Ⅱ pelvic floor muscle fibers was obviously correlated with delivery methods,gestational weeks and parity respectively.⑤ Choose the appropriate way of episiotomy(fetal head position,length,angle)would not affect the fiber strength of the pelvic floor muscles in a short period of time.⑥ Age,height and the fetus weight aren`t the risk of PFM strength within 42-60 days of research.Conclusion Pregnancy and childbirth are important influence factors on postpartum women`s pelvic floor muscle strength.Analyzing the situation and influence factors of postpartum pelvic floor muscle strength has a guiding significance for female pelvic floor muscle dysfunction.