[1]刘爱凤*,李长忠.不同第二产程时间对自然分娩的单胎足月妊娠 初产妇盆底功能的影响[J].中国计划生育和妇产科,2018,(10):81-84.
　LIU Ai-feng*,LI Chang-zhong.The influence of different secondary labor time on pelvic floor function of full-term singleton primipara with natural childbirth assisted by labor analgesia[J].Chinese Journal of Family Planning & Gynecotokology,2018,(10):81-84.
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不同第二产程时间对自然分娩的单胎足月妊娠 初产妇盆底功能的影响
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年10期
页码:
81-84
栏目:
论著与临床
出版日期:
2018-10-25

文章信息/Info

Title:
The influence of different secondary labor time on pelvic floor function of full-term singleton primipara with natural childbirth assisted by labor analgesia
作者:
刘爱凤1; 2*; 李长忠2
1. 274000山东菏泽，菏泽市牡丹人民医院产科；2. 250021山东济南，山东大学附属省立医院
Author(s):
LIU Ai-feng1; 2*; LI Chang-zhong2
1.Department of Obstetrics, Heze Mudan People's Hospital，Heze Shandong 274000, P.R.China；2.Provincial Hospital Affiliated to Shandong University，Jinan Shandong 250021，P.R.China
关键词:
第二产程; 自然分娩; 初产妇; 盆底功能障碍; 压力性尿失禁
Keywords:
second stage of labor ;  natural childbirth;  primipara;  pelvic floor dysfunction;  stress urinary incontinence
分类号:
R 71445
摘要:
目的探究不同第二产程时间对分娩镇痛辅助自然分娩的单胎足月妊娠初产妇盆底功能的影响。方法选择2016年于菏泽市牡丹人民医院进行分娩镇痛辅助自然分娩的168例单胎足月妊娠初产妇，根据第二产程时间分为产程正常组（122例）和产程延长组（46例），比较两组产妇压力性尿失禁（stress urinary incontinence，SUI）的发生率、盆腔器官脱垂（pelvic organ prolapse，POP）的发生率与分级、盆底肌阴道压力、盆底肌力损伤和盆底肌肉疲劳度。应用线性相关分析产妇盆底肌阴道压力与第二产程时间的相关性，应用多因素Logistics回归分析产妇发生盆底功能障碍的相关危险因素。结果产程正常组产妇SUI和POP的发生率（574 %、656 %）低于产程延长组（1522 %、1957 %），产程延长组的盆底肌阴道压力低于产程正常组，肌力损伤的比例和盆底肌肉疲劳度高于产程正常组，差异均有统计学意义（P<005）。线性相关分析显示，产妇I类和II类盆底肌阴道压力与第二产程时间呈负相关（P<005）。Logistics回归分析显示，体质量指数、新生儿体重和第二产程时间是产妇发生盆底功能障碍的独立危险因素。结论第二产程延长可降低产妇盆底肌阴道压力，加重盆底肌纤维损伤和疲劳度，增加盆底功能障碍性疾病的患病风险。
Abstract:
ObjectiveTo observe the influence of different secondary labor time on pelvic floor function of full-term singleton primipara with natural childbirth assisted by labor analgesia.Methods168 full-term singleton primipara with natural childbirth assisted by labor analgesia in Heze Mudan People's Hospital in 2016 were selected and divided into normal labor group (122 cases) and prolonged labor group （46 cases）according to the second stage of labor time.The incidence of stress urinary incontinence（SUI）, incidence and classification of pelvic organ prolapse(POP), pelvic floor muscle vaginal pressure, muscle strength and pelvic floor muscle fatigue of two groups were compared. The linear correlation analysis was used to investigate the correlation between vaginal pressure and secondary labor time, and the multivariate Logistic regression analysis was used to explore the risk factors of pelvic dysfunction in maternal. ResultsThe incidence of SUI and POP in the normal labor group (574 %, 656 %) was significantly lower than that in the prolonged labor group (1522 %, 1957 %),the pelvic floor vaginal pressure in the prolonged labor stage was significantly lower than that in the normal labor group. Muscle strength injury and pelvic floor muscle fatigue were significantly higher than those in the normal labor group，the difference was statistically significant（P<005）.Linear correlation analysis showed maternal type I and type Ⅱ pelvic floor vaginal pressures were significantly negatively correlated with secondary labor time(P＜005). Logistics regression analysis showed that body mass index, neonatal weight and second stage of labor time were independent risk factors for pelvic floor dysfunction. ConclusionThe prolonged second stage of labor can reduce the maternal pelvic floor muscle strength, increase the damage and fatigue of pelvic floor muscle and increase the risk of pelvic floor dysfunction.

参考文献/References:

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更新日期/Last Update: 2018-10-25