摘要
目的 经会阴超声检查评价不同分娩方式与盆腔器官脱垂（pelvic organ prolapse,POP）的相关性。方法纳入2013年8月~2015年6月在我院分娩的801例产妇为研究对象,经阴道分娩组377例,选择性剖宫产组（elective ecesarean section,ECS））424例。产后6~8周经会阴行盆底超声检查,检查前行问卷调查,本研究所有检查由三位高级职称医师完成,选取一致结论进行评价。比较经阴道分娩组和选择性剖宫产组产妇在年龄、身高、体重、BMI值及新生儿体重的差异;比较两组POP发生率的差异;在调整年龄、母亲BMI值和新生儿体重后,探讨不同分娩方式与POP发生的相关性,并进行风险评估。结果 801例产妇中年龄最大者35岁,最小20岁,平均（25.17±2.89）岁。单因素分析显示,两组产妇年龄、身高、体重、BMI及新生儿体重差异均有统计学意义（P〈0.001）。801例产妇中有POP共292例,发生率为36.5%（292/801例）。经阴道分娩组POP发生率为54.64%（206/377例）,高于选择性剖宫产组的20.3%（86/424例）;选择性剖宫产POP发生率是经阴道分娩的0.211倍（P〈0.001）。多因素Logistic分析显示,调整产妇年龄、BMI、新生儿体重后发现分娩方式与POP发生有关,比值为0.194,差异有统计学意义（P〈0.001）。结论 不同分娩方式与POP的发生有关,阴道分娩较选择性剖宫产发生POP风险增加,经会阴超声检查以其操作简便、可重复、无辐射等优势,可作为盆底功能障碍性疾病的首选检查方式。
Objective To evaluate the correlative study between pelvic organ prolapse and different delivery methods by using transperineal sonography（TPS）. Methods 801 patients in our hospital were chosen from August 2013 to June 2015, including 377 patients of vaginal delivery, 424 patients of elective ecesarean section （ECS）, which were observed by the perineum pelvic ultrasound after delivery from 6 to 8 weeks. The questionnaire survey was conducted by 3 senior professional physicians with unanimous conclusion before observation. The age, height, weight, BMI, POP occurrence and newborn of vaginal delivery group and elective ecesarean section group were compared to explore the correlation between different delivery methods and POP occurrence. Results In 801 cases, the oldest patients was 35 year old, and the youngest was 20, with average age in range of 25.17±2.89. According to univariate analysis, maternal age, height, weight, BMI and neonatal weight had differences of two groups （P〈0. 001）. 292 cases of 801 were POP （36.5%）. The POP occurrence in vaginal delivery and ECS were 54.64% and 20.3Vo （P〈0. 001）. According to multiple logistic regression analysis, adjustment estimation for maternal age, BMI, newborn weight were related to POP in childbirth way with ratio of 0. 194（P〈0. 001）. Conclusion The pelvic organ prolapse is correlated with different delivery methods. The risk of POP occurrence in vaginal delivery is higher than that of ECS. The transperineal sonography evaluation is the priority way of diagnosis, which is very convenient, with no harm, repeation and precise.
出处
《西部医学》
2016年第9期1302-1305,1309,共5页
Medical Journal of West China
基金
四川省卫生厅科研课题(130529)
成都市卫生局科学研究基金(2014114)
