摘要
目的了解本地区产后妇女盆底肌损伤的的发生情况并分析其影响因素及防治措施,为生产妇女盆底肌损伤的早期防治提供临床依据,旨在提高产后妇女的生活质量。方法选择2016年8月~2018年12月期间在医院产科分娩并于产后42d在门诊进行产后复查的640例产妇为研究对象,通过自制问卷调查及住院病历资料对产妇一般情况、妊娠及分娩情况进行分析,并检测盆底肌力,分析损伤情况。结合病历资料及问卷调查,对产后妇女盆底肌损伤的发病影响因素进行分析,并提出防治措施。结果通过对640例产妇进行盆底肌力的阴道触诊和盆底功能的筛查,结果显示:盆底肌力正常的产妇175例(27.34%),肌力异常的产妇465例(72.66%),尿失禁173例(27.03%),盆腔脏器脱垂278例(43.44%)。其中,盆底I类肌纤维肌力异常465例(72.66%)、盆底Ⅱ类肌纤维的肌力异常396例(61.88%);盆底I类肌纤维疲劳度异常493例(77.03%)、盆底Ⅱ类肌纤维疲劳度异常427例(66.72%),阴道动态压力异常489例(76.41%)。将与产后妇女盆底肌力损伤有关的分娩方式、产次、新生儿体质量、孕期体质量增加、文化程度、会阴裂伤6个变量引入到logistic回归分析,建立多因素回归模型,结果显示:阴道分娩、分娩产次多、孕期体质量增加多、巨大儿与产后妇女盆底肌力损伤显著相关(P<0.05,OR=8.518、1.713、1.032、1.142)。结论本地区产后妇女盆底肌损伤的发生率较高,盆底肌损伤与分娩方式、产次、孕期体质量增加、新生儿体质量等因素密切相关,应在早期进行预防治疗,减少产后妇女盆底肌损伤的发生。
Objective To discuss the incidence of pelvic floor muscle injury in postpartum women in Hangzhou,and to analyze its influencing factors.Methods A total of 640 maternal women who delivered babies in our hospital from August 2016 to December 2018 and received postpartum examinations in 42 days after giving births were recruited in the study.A self-designed questionnaire survey was conducted and inpatient medical records were reviewed to collect demographical information,pregnancy and childbirth.Pelvic floor muscle strength and pelvic floor function were assessed and factors affecting the incidence of pelvic floor muscle injury in postpartum women were analyzed.Results Out of 640 total subjects,465(72.66%)had abnormal pelvic floor muscle strength,including 173 with urinary incontinence and 278 with pelvic organ prolapse(43.44%).Among women with abnormal pelvic floor muscle strength,465 were classified as pelvic floor type I muscle fiber dysfunction and,396 as abnormal muscle strength of pelvic floor type II muscle fibers,493 as abnormal pelvic floor type I muscle fiber fatigue and 427 as abnormal type II muscle fiber fatigue and 489 as abnormal vaginal dynamic pressure.Multivariate logistic analysis showed that vaginal delivery,multiple childbirths,gaining weight during pregnancy,heavy body weight of newborn were significantly correlated with the pelvic floor muscle injury in postpartum women(P<0.05)with the OR values of 8.518,1.713,1.032 and1.142.Conclusions The incidence of pelvic floor muscle injury in postpartum women in Hangzhou is relatively high.The pelvic floor muscle injury is closely related to the delivery method,number of childbirths,increase body weight during pregnancy and the body weight of the newborn.Preventive measures should be taken in the early stage to reduce the incidence of basal muscle injury.
作者
陆荣仙
王澜静
LU Rong-xian;WANG Lan-jing(Obstetrical Rehabilitation Center,Hangzhou Fuyang Women and Children Hospital,Hangzhou,Zhejiang 311400,China)
出处
《中国预防医学杂志》
CAS
CSCD
2020年第6期654-657,共4页
Chinese Preventive Medicine
基金
浙江省中医药科技计划基金资助项目(20162A072)
关键词
盆底肌力
损伤
产后
妇女
影响因素
Pelvic floor muscle strength
Injury
Postpartum
Women
Influencing factors
