阴道顺产分娩和产钳助产对产妇盆底功能及近远期并发症的影响

目的研究阴道顺产分娩与产钳助产对产妇盆底功能及近远期并发症的影响。方法选取2017年3月—2020年3月于我院初次分娩的产妇120例,按照分娩时是否产钳助产分为阴道顺产分娩组(n=68)与产钳助产组(n=52)。比较两组产妇产后6周、3个月、6个月盆底肌电值、盆底肌力、肛提肌损伤及近远期并发症情况。结果产钳助产组产妇产后6周、3个月、6个月前静息平均肌电值、快肌最大肌电值、混合肌平均肌电值及慢肌平均肌电值均显著低于阴道顺产分娩组(P<0.01);产钳助产组产妇产后6周、3个月、6个月盆底肌力显著低于阴道顺产分娩组(P<0.05或P<0.01);产钳助产组产妇产后6周、3个月、6个月肛提肌损伤、肛提肌撕裂发生率高于阴道顺产分娩组,产后6个月肛提肌裂孔面积增大发生率高于阴道顺产分娩组,差异有统计学意义(P<0.05或P<0.01);产钳助产组产妇近、远期总并发症发生率显著高于阴道顺产分娩组(P<0.05或P<0.01)。结论产钳助产与阴道顺产分娩相比,对产妇盆底肌力、肛提肌损伤更为严重,并增加了产后并发症的发生风险。

Effects of Vaginal Delivery and Forceps Midwifery on Pelvic Floor Function and Short-term and Long-term Complications of Puerperae

Objective To study the effects of vaginal delivery and forceps midwifery on pelvic floor function and short-term and long-term complications of puerperae.Methods A total of 120 primary puerperae who gave birth in our hospital from March 2017 to March 2020 were selected and divided into vaginal delivery group(n=68)and forceps midwifery group(n=52)according to whether forceps midwifery was performed during delivery.Pelvic floor myoelectric voltage,pelvic floor muscle strength,levator ani muscle injury and short-term and long-term complications were compared between the two groups at 6 weeks,3 months and 6 months after delivery.Results The pre-resting mean myoelectric voltage,maximal myoelectric voltage of fast muscle,mean myoelectric voltage of mixed muscle and mean myoelectric voltage of slow muscle at 6 weeks,3 months and 6 months after delivery in forceps midwifery group were significantly lower than those in vaginal delivery group(P<0.01).At 6 weeks,3 months and 6 months after delivery,the pelvic floor muscle strength in forceps midwifery group was significantly lower than that in vaginal delivery group(P<0.05 or P<0.01).At 6 weeks,3 months and 6 months after delivery,the incidence rates of levator ani muscle injury and levator ani muscle tear in forceps midwifery group were significantly higher than those in vaginal delivery group,and the incidence rate of levator ani hiatus area enlargement at 6 months after delivery was higher than that in vaginal delivery group(P<0.05 or P<0.01).The total incidence rate of short-term and long-term complications of puerperae in forceps midwifery group was significantly higher than that in vaginal delivery group(P<0.05 or P<0.01).Conclusion Compared with vaginal delivery,forceps midwifery is more serious for the pelvic floor muscle strength and levator ani muscle injury,which also increases the risk of postpartum complications.