新产程标准管理下第二产程时长对产妇盆底功能近期影响研究

发布时间：2018-05-15 19:49

  本文选题：初产妇 + 第二产程　； 参考：《中国实用妇科与产科杂志》2017年12期

【摘要】：目的探讨新产程标准管理下第二产程时长对产妇盆底功能的近期影响。方法回顾性分析新产程标准管理下2016-01-01—2016-12-31在成都市妇女儿童中心医院阴道分娩的单胎足月头先露活产初产妇,孕前均排除压力性尿失禁、生殖道畸形和盆底功能障碍性疾病,孕期无严重内外科合并症和并发症并且在年龄、孕前体重指数、孕期增重、新生儿出生体重无明显差异者共174例,产程中均行硬膜外麻醉分娩镇痛。A组(研究组)根据第二产程时长(t)分为3组:A1组(34例)2 h≤t2.5 h;A2组(20例)2.5 h≤t3 h;A3组(20例)t≥3 h。同期t2 h的产妇共100例作为B组(对照组)。于产后42 d进行问卷调查及盆底POP-Q评分分度、器官脱垂、尿失禁和综合肌力测试,比较第二产程时长对女性盆底功能的影响。结果 4组在POP-Q评分Aa点(阴道前壁距处女膜3 cm点)、Ba点(阴道前壁脱出距处女膜最远点)、C点(前穹窿或阴道残端距处女膜点)、pb(会阴体长度)、tvl(阴道总长度)以及D点(阴道后穹窿距处女膜点)评分上差异有统计学意义(P0.05);进一步两两比较发现:A3组在Aa、Ba、tvl、C和D点评分与另3组差异有统计学意义;A2、A3组在pb与另两组差异有统计学意义;POP-Q分度阴道后壁脱垂A3组与另3组间差异有统计学意义;压力性尿失禁发生率各组之间差异有统计学意义;盆底肌力A3组与另3组间差异有统计学意义。结论第二产程时长对产后近期盆底功能有影响,当≥3 h时会成为产后盆底功能障碍性疾病的高危因素。故产程中需严密监测进展,及时处理异常因素,控制第二产程时长3 h。
[Abstract]:Objective to investigate the short-term effect of the duration of the second labor on pelvic floor function of puerpera under the standard management of new labor process. Methods A retrospective analysis was made on the single full term live primipartum delivered in the vagina of Chengdu Women's and Children's Center Hospital from January to January 2016-12-31 under the new labor standard. Stress urinary incontinence, genital tract malformation and pelvic floor dysfunction were excluded before pregnancy. There were no severe complications and complications during pregnancy, and 174 cases had no significant difference in age, body mass index (BMI) before pregnancy, weight gain during pregnancy and birth weight of newborns. Group A (study group) was divided into 3 groups according to the duration of the second stage of labor: 3 groups: group A (34 cases) with 2 h or less t 2.5 h and A 2 group with 20 cases with 2. 5 h 鈮，

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