摘要
目的:研究分娩方式对女性前盆腔形态结构与功能的远期影响。方法:将64例产后5年以上的女性分为经阴道分娩组(32例)和选择性剖宫产组(32例),通过病史采集、妇科检查评估压力性尿失禁(SUI)的患病情况,行经会阴盆底超声检查获取其在静息状态及Valsalva状态下的前盆腔脏器形态结构图像并测量与SUI相关的参数。结果:经阴道分娩组远期SUI患病率和膀胱膨出发生率高于选择性剖宫产组(P<0.05)。经阴道分娩组的尿道旋转角大于选择性剖宫产组(P<0.05)。静息状态下膀胱颈至耻骨联合下缘的距离和膀胱尿道后角、Valsalva状态下膀胱颈至耻骨联合下缘的距离(BSD)和膀胱尿道后角、膀胱颈移动度、逼尿肌厚度的差异无统计学意义(P>0.05)。结论:不同分娩方式对女性前盆腔脏器结构与功能的远期影响存在差异,经阴道分娩女性远期SUI患病率增高可能与膀胱膨出及尿道活动度增加有关。
Objective： To research the long - term effects of delivery modes on structure and function of female anterior pelvic or- gans. Methods： Sixty - four women who gave birth to their babies more than five years were divided into vaginal delivery group and selective cesarean section group, 32 women in each group. Their medical histories were collected, the prevalence of stress urinary incontinence （SUI） was evaluated by gynecological examination, the images of morphology and structure of anterior pelvic organs at rest and in Valsalva state were obtained by transperineal pelvic floor sonography, SUI related parameters were measured. Results： The long - term incidence rates of SUI and bladder prolapse in vaginal delivery group were statistically significantly higher than those in selective cesarean section group （P 〈 0. 05） . Urethral rotation angle in vaginal delivery group was statistically significantly larger than that in selective cesarean section group （P 〈 0.05 ） . There was no statistically significant difference in the distance between bladder neck and lower margin of symphysis pubis and the posterior urethra - vesical angle at rest, the distance between bladder neck and lower margin of symphysis pubis and the posterior urethra - vesical angle, bladder neck mobility and the thickness of detrusor between the two groups （P 〉 O. 05 ） . Conclusion： The long - term effects of different delivery modes on structure and function of female anterior pelvic organs are different, the increase of incidence rate of SUI among the women adopting vaginal delivery may be correlated with bladder prolapse and larger urethral rotation angle.
出处
《中国妇幼保健》
CAS
北大核心
2014年第33期5380-5382,共3页
Maternal and Child Health Care of China
基金
科技惠民计划项目〔2013GS650104〕
关键词
分娩方式
前盆腔脏器
经会阴盆底超声
压力性尿失禁
Delivery mode
Anterior pelvic organ
Transperineal pelvic floor sonography
Stress urinary incontinence
