标题：剖宫产与阴道分娩对产妇产后盆底肌电值、盆底组织状态及下尿路功能的影响

      作者：陈晓琴，陈秋娜，宋岩    深圳市龙华区中心医院产科，广东 深圳 518100

      卷次： 2019年30卷13期

      【摘要】 目的 比较剖宫产与阴道分娩对产妇产后盆底肌电值、盆底组织状态及下尿路功能的影响，为产妇分娩方式的选择及产后恢复措施的制定提供参考依据。方法 选取2018年6~12月期间深圳市龙华区中心医院产科收治的60例阴道分娩产妇为A组，同时期的60例剖宫产产妇为B组。比较两组产妇产后6周、12周及24周的盆底肌电值(活力值、峰值及功值)、盆底组织状态[膀胱颈旋转角度(θ)、静息与压力状态下的尿道膀胱后角(Ar与As)]及下尿路功能[最大尿流率(RMF)、最大尿意膀胱容量(VMCC)及膀胱顺应性(BC)]方面的监测指标。结果 两组产妇产后12周及24周的活力值、峰值及功值，盆底组织状态θ、Ar及As，下尿路功能指标RMF、VMCC及BC均好于产后6周，B组产后6周及12周的盆底肌电值及盆底组织状态均好于A组，差异均有统计学意义(P<0.05)，但两组产妇产后24周的盆底肌电值及盆底组织状态指标比较，以及产后6周、12周及24周的下尿路功能指标比较，差异均无统计学意义(P>0.05)。结论 剖宫产对产妇产后短期的盆底肌电值及盆底组织状态的不良影响小于阴道分娩，较长时间的不良影响差异不明显，而两种分娩方式对下尿路功能的影响差异较小。
      【关键词】 剖宫产；阴道分娩；产妇；产后盆底肌电值；产后盆底组织状态；产后下尿路功能状态
      【中图分类号】 R719.8 【文献标识码】 A 【文章编号】 1003—6350（2019）13—1704—04

Influence of cesarean section and vaginal delivery for the postpartum pelvic floor electromyography, pelvic floortissue state and lower urinary tract function of delivery women.
CHEN Xiao-qin, CHEN Qiu-na, SONG Yan.Department of Obstetrics, Central Hospital of Longhua District of Shenzhen, Shenzhen 518100, Guangdong, CHINA
【Abstract】 Objective o observe and compare the influence of cesarean section and vaginal delivery for thepostpartum pelvic floor electromyography, pelvic floor tissue state and lower urinary tract function indexes of deliverywomen, in order to provide reference for the choice of delivery modes and the formulation of postpartum recovery mea-sure of delivery women. Methods A total of 60 delivery women with vaginal delivery in Department of Obstetrics atCentral Hospital of Longhua District of Shenzhen from June 2018 to December 2018 were selected as group A, and 60delivery women with cesarean section at the same time were selected as the group B. Then the pelvic floor electromyog-raphy (activity value, peak value and work value), pelvic floor tissue state (bladder neck rotation angle [θ], resting andpressure urethral vesical posterior horn [Ar and As]) and lower urinary tract function indexes (maximum urinary flowrate [RMF], maximum urinary bladder volume [VMCC] and bladder compliance [BC]) of two groups at 6th，12 th and 24 thweek after the delivery were compared. Results The pelvic floor electromyography included activity value, peak valueand work value, pelvic floor tissue state (θ, Ar and As), lower urinary tract function indexes included (RMF, VMCC and BC)of two groups at 12th and 24 th week after the delivery were all significantly better than those at 6th week after the deliv-ery, and the pelvic floor electromyography and pelvic floor tissue state indexes of the group B at 6th and 12th week afterthe delivery were all significantly better than those of the group A (all P<0.05). There were no statistically significant dif-ferences in the pelvic floor electromyography and pelvic floor tissue state indexes at 24th week after the delivery and low-er urinary tract function indexes at 6th, 12th and 24th week after the delivery between the two groups (all P>0.05).Conclusion The bad influence of cesarean section for the postpartum pelvic floor electromyography and pelvic floortissue state of delivery women at short-term are smaller than those of vaginal delivery, and the differences of bad influ-ence at long-term are not obvious, while the influence's differences of two types of delivery for the lower urinary tractfunction are smaller.
      【Key words】 Cesarean section; Vaginal delivery; Delivery women; Postpartum pelvic floor electromyography;Postpartum pelvic floor tissue state; Postpartum lower urinary tract function