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目的:探讨无保护分娩技术对单胎初产妇分娩后盆底功能的影响。方法:选择2014年9月至11月在东南大学附属中大医院产科住院、足月妊娠并经阴道分娩的符合入组条件的单胎初产妇进行研究,应用随机数字表法将产妇分为无保护分娩技术组与会阴侧切术组。于产后42 d左右运用手测盆底肌力及盆腔器官脱垂的诊断标准(pelvic organ prolapse quantitive examination,POP-Q)评分等评价产妇的盆底功能。结果:无保护分娩技术组52例,会阴侧切术组51例。两组产妇在年龄、文化程度以及流产次数等方面差异均无统计学意义(P>0.05)。产后盆底功能:两组产妇产后42 d左右尿失禁患病率比较差异无统计学意义(P=0.750);两组产妇POP-Q评分比较差异也无统计学意义(P=0.546);盆底肌肌力比较差异亦无统计学意义(P=0.631)。结论:无保护分娩技术不增加产妇产后尿失禁率及盆腔器官脱垂风险,对盆底肌肌力的影响与会阴侧切术比较无明显差异。
Objective: To investigate the effect of unprotected childbirth on pelvic floor function after delivery of singleton primipara. Methods: From January to November 2014, we selected maternal single-fetus women who were hospitalized in full-term pregnancy with vaginal delivery in the obstetrics and gynecology department of the Affiliated Zhongda Hospital of Southeast University from September to November 2014. The random number table Protection of childbirth technical group and episiotomy lateral group. At 42 days postpartum, pelvic floor function was evaluated by pelvic organ prolapse quantitive examination (POP-Q). Results: 52 cases of unprotected childbirth technical group, 51 cases of episiotomy. The two groups of maternal age, education level and the number of miscarriage no significant difference (P> 0.05). Postpartum pelvic floor function: There was no significant difference in the prevalence of urinary incontinence between the two groups at postnatal day 42 (P = 0.750); there was no significant difference in POP-Q score between the two groups (P = 0.546) There was no significant difference in muscle strength between basal muscles (P = 0.631). Conclusion: Unprotected childbirth does not increase the rate of postpartum urinary incontinence and the risk of pelvic organ prolapse. The effect on pelvic floor muscle strength has no significant difference compared with that of episiotomy.