不同待产方式对初产妇产后近期盆底功能影响.docVIP

不同待产方式对初产妇产后近期盆底功能的影响 　　【摘要】 目的：比较不同待产方式对初产妇产后近期盆底功能的影响，寻求最有益的待产方式。方法：选取2015年6月-2016年2月于郑州大学第三附属医院分娩的初产妇，按自愿分为水中待产组69例（简称水中组）、传统待产组95例（简称传统组）、硬膜外麻醉待产?M75例（简称药物组）。收集阴道分娩产妇产程、会阴侧切及会阴裂伤、1 min和5 min新生儿Apgar评分、孕期及产后42 d压力性尿失禁（SUI）、盆腔器官脱垂分度（POP-Q）和盆底电生理指标，并进行统计分析。结果：水中组与传统组相比中转剖宫产率、会阴侧切率、产后42 d SUI发生率降低（P0.017），Aa指示点上移（P0.017）。水中组与药物组相比第一、二产程时间缩短，会阴侧切率降低，水中组Ⅰ类和Ⅱ类肌纤维肌力优于药物组，Aa指示点上移（P0.017）。结论：水中待产可降低初产妇剖宫产率、会阴侧切率及产后42 d SUI发生率，可减轻初产妇产后近期盆底电生理指标损伤程度、盆底器官脱垂程度，水中待产可能对盆底功能有保护性作用。 　　【关键词】 水中待产； 盆底电生理； 压力性尿失禁； 盆腔器官脱垂 　　【Abstract】 Objective：To compare different laboring methods on primipara pelvic muscle strength in the early postpartum period，seek the most beneficial laboring way.Method：From June 2015 to 2016 February the primiparas were selected，by voluntary they were divided into laboring in water 69 cases，traditional laboring 95 cases and epidural anesthesia laboring 75 cases.The underwent vaginal delivery，episiotomy and perineal laceration，infants Apgar score，SUI during pregnancy and at 42 days after delivery，POP-Q and pelvic floor electrical physiological indexes of vaginal delivery women were collectted and statistical analyzed.Result：The water group compared with traditional group，the cesarean section rate，perineal incision rate and the incidence of postpartum 42 days SUI were decreased（P0.017），and Aa indicator point up（P0.017）.Compared with drug group，the water group of the first and second stage of labor time and episiotomy rate reduced， muscle strength of classⅠand class Ⅱ were better（P0.017），Aa indicator point up（P0.017）.Conclusion：According to primipara，laboring in water could reduce the rate of cesarean section，episiotomy and SUI 42 days after birth.In the early postpartum period，it could reduce the degree of postpartum pelvic floor electrophysiological index injury and pelvic organ prolapse.It may have a protective effect on the pelvic floor function. 　　【Key words】 Laboring in water； Pelvic floor electrophysiology； Stress urinary incontinence； Pelvic organ pro