初产妇产后早期盆底功能障碍性疾病与分娩相关因素分析

王琦; 程贤鹦

doi:10.16766/j.cnki.issn.1674-4152.002281

初产妇产后早期盆底功能障碍性疾病与分娩相关因素分析

doi: 10.16766/j.cnki.issn.1674-4152.002281

王琦,
程贤鹦^,

浙江医院妇产科，浙江杭州 310030

基金项目:

浙江省中医药科技计划项目 2018ZB008

详细信息

通讯作者:
程贤鹦，E-mail：bomibole@163.com

中图分类号: R711.5 R714.46
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- 文章访问数: 219
- HTML全文浏览量: 262
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2020-08-23
- 网络出版日期: 2022-03-03

Analysis between postpartum pelvic floor dysfunction and delivery related factors in primipara

WANG Qi,
CHENG Xian-ying^,

Department of Obstetrics and Gynecology, Zhejiang Hospital, Hangzhou, Zhejiang 310030, China

摘要

摘要: 目的探讨初产妇分娩相关因素对产后早期盆底功能障碍性疾病(PFD)的影响。方法选取浙江医院妇产科2020年3—8月就诊分娩的初产妇为研究对象，通过入选与排除标准筛选，最终入选患者167例。依据产妇产后42 d复查结果分为患有盆底功能障碍性疾病组(PFD组，85例)、未患有盆底功能障碍性疾病组(非PFD组，82例)。比较2组产妇分娩方式、分娩进程和胎儿情况。结果 (1) PFD组患者剖宫产14例，非PFD组剖宫产29例，PFD组患者剖宫产率显著低于非PFD组(χ²=5.233，P＜0.05)。PFD组产钳助产23例，非PFD组产钳助产1例，PFD组产钳助产率显著高于非PFD组(χ²=20.167，P＜0.01)。(2)PFD组患者正常产程14例，非PFD组正常产程39例，PFD组患者正常产程的人数显著低于非PFD组(χ²=11.792，P＜0.01)。PFD组患者第一产程和第二产程异常的例数分别为27例、21例，非PFD组患者第一产程和第二产程异常的例数分别为7例、4例，PFD组第一产程和第二产程异常的发生率显著高于非PFD组(均P＜0.01)。(3)PFD组胎儿分娩时持续性枕横位39例、持续性枕后位20例，非PFD组胎儿分娩时持续性枕横位6例、持续性枕后位4例，PFD组胎儿分娩时持续性枕横位、枕后位的发生率显著高于非PFD组(均P＜0.01)。(4)PFD组巨大胎儿10例，非PFD组巨大胎儿2例，PFD组巨大胎儿发生率显著高于非PFD组(χ²=5.333，P＜0.05)。结论在分娩中应密切关注产程和胎儿情况，及时发现产程异常情况，给予针对性处理，从而预防产后早期盆底功能障碍性疾病的发生。
- 盆底功能障碍性疾病 /
- 分娩相关因素 /
- 初产妇
Abstract: Objective To explore the effect of delivery related factors on early pelvic floor dysfunction (PFD) in primipara. Methods By convenient sampling, 167 primiparas from March to August 2020 were selected as the research objects. All primiparas were screened by inclusion and exclusion criteria. According to the results of their routine follow-up 42 days after delivery, the primiparas were divided into PFD and non-PFD groups. The delivery mode, delivery process and fetal condition were compared between the two groups. Results (1) The PFD group had 14 cases of caesarean section, and the non-PFD group had 29 cases. The caesarean-section rate in the PFD group was significantly lower than that in the non-PFD group (χ²=5.233, P < 0.05). The PFD group had 23 cases of forceps delivery, and the non-PFD group had 1 case. The forceps delivery rate in the PFD group was significantly higher than that in the non-PFD group (χ²=20.167, P < 0.01). (2) The PFD group had 14 cases of natural process of labor, and the non-PFD group had 39 cases. The number of natural process of labor in the PFD group was significantly lower than that in the non-PFD group (χ²=11.792, P < 0.01). The numbers of abnormal first and second stages of labor in the PFD group were 27 and 21, whereas those in the non-PFD group were 7 and 4, respectively. The incidences of abnormal first and second stage of labor in the PFD group were significantly higher than those of the non-PFD group (all P < 0.01). (3) The numbers of persistent occipitotransverse position and persistent occipitoposterior position in the PFD group were 39 and 20, whereas those in the non-PFD group were 6 and 4, respectively. The incidences of persistent occipitotransverse position and persistent occipitoposterior position in the PFD group were significantly higher than those in the non-PFD group (all P < 0.01). (4) The PFD group had 10 cases of foetal macrosomia, and the non-PFD group had 2 cases. The incidence of foetal macrosomia in the PFD group was significantly higher than that in the non-PFD group (χ²=5.333, P < 0.05). Conclusion We should pay close attention to the process of labor and foetal condition. When abnormal labor process occurs, targeted treatment is needed. Only in this way can the incidence of pelvic floor dysfunction be reduced.
- Pelvic floor dysfunction /
- Delivery related factors /
- Primipara

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表 1 PFD组与非PFD组初产妇分娩方式、分娩进程比较(例)

组别	例数	分娩方式			分娩进程
组别	例数	自然分娩	产钳助产	剖宫产	正常产程	急产	第一产程活跃期延长	第二产程延长
PFD组	85	48	23	14	14	9	27	21
非PFD组	82	52	1	29	39	3	7	4
χ²值		25.514			18.620	2.987	13.805	12.813
P值		< 0.001			< 0.001	0.084	< 0.001	< 0.001

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表 2 PFD组与非PFD组胎儿情况比较(例)

组别	例数	持续性枕横位	持续性枕后位	巨大胎儿
PFD组	85	39	20	10
非PFD组	82	6	4	2
χ²值		31.533	11.790	5.442
P值		< 0.001	0.001	0.032

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