摘要
目的探讨会阴侧切与自然裂伤对自然分娩初产妇产后盆底功能的影响。方法回顾性分析2019年8月至2020年8月大连市妇女儿童医疗中心收治的68例自然分娩初产妇的临床资料,根据助产方式不同将其分为会阴侧切组(34例)和会阴自然裂伤组(34例)。会阴侧切组进行会阴侧切,会阴自然裂伤组发生会阴裂伤。于产后42 d比较两组的盆底功能、会阴疼痛程度与盆底肌肌电值、性功能、并发症。结果两组的盆底功能比较,差异无统计学意义(P>0.05);会阴侧切组的视觉模拟评分法(VAS)评分高于会阴自然裂伤组,盆底肌肌电值低于会阴自然裂伤组,差异有统计学意义(P<0.05);会阴侧切组女性性功能量表(FSFI)中的性唤起、阴道润滑程度、性高潮、性生活满意度评分低于会阴自然裂伤组,差异有统计学意义(P<0.05);会阴侧切组的并发症总发生率为26.47%,高于会阴自然裂伤组的5.88%,差异有统计学意义(P<0.05)。结论会阴侧切虽能预防自然分娩引起的会阴严重撕裂伤,但较会阴自然裂伤更易损伤初产妇盆底肌肉、盆底神经,加剧会阴处伤口疼痛,降低性生活质量。产前需对初产妇进行详细检查,避免手术滥用影响患者身心健康。
Objective To explore the influence of episiotomy and natural laceration on pelvic floor function of primipara after natural delivery.Methods The clinical data of 68 primiparas with natural childbirth in Dalian Women and Children Medical Center from August 2019 to August 2020 were retrospectively analyzed.They were divided into the lateral episiotomy group(34 cases)and the natural perineal laceration group(34 cases)according to different midwifery methods.Episiotomy was performed in the lateral episiotomy group,and perineal laceration occurred in the natural perineal laceration group.The pelvic floor function,perineal pain,pelvic floor myoelectric value,sexual function and complications of the two groups at 42 days after delivery were compared.Results There was no significant difference in pelvic floor function between the two groups(P>0.05).The visual analogue scale(VAS)score of the lateral episiotomy group was higher than that of the natural perineal laceration group,and the pelvic floor myoelectric value of the lateral episiotomy group was lower than that of the natural perineal laceration group,the differences were statistically significant(P<0.05).The scores of sexual arousal,vaginal lubrication,orgasm and sexual life satisfaction of the female sexual function index(FSFI)in the lateral episiotomy group were lower than those in the natural laceration group,the differences were statistically significant(P<0.05).The total incidence of complications in the lateral episiotomy group was 26.47%,which was higher than 5.88%in the natural laceration group,the difference was statistically significant(P<0.05).Conclusion Lateral episiotomy can prevent severe perineal laceration caused by natural childbirth,but it is more likely to damage basin muscles and nerves of primipara than natural perineal laceration,aggravate perineal wound pain,and reduce the quality of sexual life.Prenatal examination should be carried out for primipara to avoid hand abuse affecting patients′physical and mental health.
作者
王莹
孙蓓
孙琳
李海英
WANG Ying;SUN Bei;SUN Lin;LI Hai-ying(Delivery Room,Chunliuyuan District of Dalian Women and Children Medical Center(Group),Liaoning Province,Dalian116011,China)
出处
《中国当代医药》
CAS
2021年第29期118-120,124,共4页
China Modern Medicine
基金
辽宁省大连市科技计划项目(20121552)。
关键词
自然分娩
初产妇
会阴侧切
自然裂伤
盆底功能
性功能
Natural childbirth
Primipara
Lateral episiotomy
Natural laceration
Pelvic floor function
Sexual function
