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目的:探讨不同的分娩方式对产后早期盆底肌力的影响。方法:纳入120例初产妇,按照分娩方式的不同,分为阴道分娩组76例和剖宫产组44例,对两组产妇产后的盆底肌力以及盆腔器官脱垂(pelvic organ prolapse,POP)情况进行评定,对肌力在Ⅱ级以下者,给予积极的电刺激联合生物反馈机制进行干预治疗。结果:阴道分娩组的阴道前壁脱垂率为92.1%,阴道后壁脱垂率为73.7%,子宫脱垂率为30.3%,剖宫产组分别为61.4%、18.2%和13.7%,两组对比,阴道分娩组的上述指标发生率均显著高于剖宫产组(P<0.05);产后6-8周时,阴道分娩组的盆底肌力受损率明显高于剖宫产组(P<0.05),但随着对肌力受损产妇进行盆底肌肉功能训练的干预,在产后3个月和6个月,阴道分娩组的肌力受损率明显下降,较产后6-8周时差异有显著性(P<0.05);同时,在产后6个月的受损率比较,两组未见统计学差异(P>0.05)。结论:虽然阴道分娩对盆底肌力的影响更为明显,产后POP的发生率较高,但产后给予积极的功能训练干预可有效改善盆底肌力,预后较为可观。因此,在产妇分娩时,不应该为了避免对盆底肌力的影响而刻意选择剖宫产。
Objective: To investigate the effect of different modes of delivery on pelvic floor muscle strength in early postpartum period. Methods: A total of 120 primiparous women were enrolled. According to different modes of delivery, they were divided into vaginal delivery group (n = 76) and cesarean section group (n = 44). The pelvic floor muscle strength and pelvic organ prolapse ) Assessment of the situation, muscle strength in grade Ⅱ or less, to give a positive electrical stimulation combined with biological feedback mechanism for intervention. Results: The vaginal delivery group had anterior vaginal prolapse rate of 92.1%, vaginal posterior wall prolapse rate of 73.7%, uterine prolapse rate of 30.3%, cesarean section group were 61.4%, 18.2% and 13.7%, respectively, two Group, vaginal delivery group the incidence of these indicators were significantly higher than the cesarean section group (P <0.05); 6-8 weeks postpartum vaginal delivery group pelvic floor muscle damage rate was significantly higher than the cesarean section group (P <0.05). However, with the intervention of pelvic floor muscle function training, the rate of muscle damage in vaginal delivery group decreased significantly at 3 months and 6 months postpartum, There was significant difference between the two groups at 8th week (P <0.05). Meanwhile, there was no significant difference between the two groups in the damage rate at 6 months postpartum (P> 0.05). Conclusion: Although vaginal delivery has a more obvious effect on pelvic floor muscle strength and a higher incidence of postpartum POP, positive postoperative functional training intervention can effectively improve pelvic floor muscle strength with a good prognosis. Therefore, in the delivery of mothers, should not be in order to avoid the impact of pelvic floor muscle and deliberate choice of cesarean section.