|本期目录/Table of Contents|

[1]王帅男,黄惠娟.产后盆底肌力情况及影响因素分析[J].医学研究与战创伤救治(原医学研究生学报),2017,19(02):121-125.[doi:10.3969/j.issn.1672-271X.2017.02.003]
　WANG Shuai-nan,HUANG Hui-juan.The correlation analysis of the female pelvic floor muscle strength andinfluencing factors of pelvic floor muscle strength disorder[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(02):121-125.[doi:10.3969/j.issn.1672-271X.2017.02.003]
点击复制

产后盆底肌力情况及影响因素分析()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第19卷
期数:
2017年02期
页码:
121-125
栏目:
出版日期:
2017-03-20

文章信息/Info

Title:
The correlation analysis of the female pelvic floor muscle strength andinfluencing factors of pelvic floor muscle strength disorder
作者:
王帅男; 黄惠娟
350025福州，南京军区福州总医院妇产科
Author(s):
WANG Shuai-nan;  HUANG Hui-juan
(Department of Obstetrics and Gynecology, Fuzhou General Hospital of Nanjing Military Region, PLA, Fuzhou 350025,Fujian,China)
关键词:
妊娠; 分娩; 盆底肌力
Keywords:
Gestation;  Delivery;  Pelvic floor muscle strength
分类号:
R246.3
DOI:
10.3969/j.issn.1672-271X.2017.02.003
文献标志码:
A
摘要:
目的 评估产后女性盆底肌力的状态，分析影响产后女性盆底肌力评级的因素。方法 以2014年3月至2016年2月在南京军区福州总医院接受盆底肌力检测的产后女性共2188例作为研究对象，利用PHENIX 2诊断系统平台，结合评价盆底肌肉综合肌力的指标Oxford评分（MOS）对盆底不同类别的肌纤维进行肌力评级，并对影响肌力评级的相关因素进行相关统计学分析。结果 ①PHENIX评估和MOS评分对盆底肌力的评定无显著差异（P＞0.05）。②近4/5的产后女性盆底肌力的异常。③孕前体重越大及孕前BMI越小，盆底Ⅰ类肌异常的风险越大；而产后体重越小及产后BMI越大，盆底Ⅰ类肌的风险越大。④顺产、孕周和产次的增加，都可导致盆底Ⅱ类肌纤维肌力异常的风险增加。⑤选择适当的会阴切开方式（胎头位置、长度、角度）在短时间内不会影响盆底肌纤维肌力。⑥在42～60 d的研究范围内，年龄、身高、胎儿体重不是影响盆底肌力的相关因素。结论 妊娠及分娩是影响产后女性盆底肌力的重要因素，通过对产后盆底肌力情况及影响因素进行分析，对女性盆底肌功能障碍的防治具有指导意义。
Abstract:
Objective To evaluate the status of women′s pelvic floor muscle (PFM) strength and analysis influencing factors of PFM strength during postpartum period.Methods There are included 2188 postpartum women who received PFM testing in Fuzhou General Hospital of Nanjing Military Region. The different muscle fibers of PFM strength was detected by PHENIX 2 diagnostic system and modified Oxford scale (MOS). Simultaneously, the influencing factors were analysed by statistical Methods .Results ①There was no significant difference in pelvic floor muscle strength between PHENIX evaluation and MOS score. ② Nearly 4/5 postpartum women suffered from pelvic floor muscle disorder. ③ The people will bear more risk in type Ι pelvic floor muscle fibers disorder who have more weight and lower BMI before pregnancy, and lower weight and more BMI after birth. ④ Type ΙI pelvic floor muscle fibers was obviously correlated with delivery Methods , gestational weeks and parity respectively. ⑤ Choose the appropriate way of episiotomy (fetal head position, length, angle) would not affect the fiber strength of the pelvic floor muscles in a short period of time. ⑥ Age, height and the fetus weight aren′t the risk of PFM strength within 42-60 days of research.Conclusion Pregnancy and childbirth are important influence factors on postpartum women′s pelvic floor muscle strength. Analyzing the situation and influence factors of postpartum pelvic floor muscle strength has a guiding significance for female pelvic floor muscle dysfunction.

参考文献/References:

[1]Gyhagen M, kervall S, Milsom I .Clustering of pelvic floor disorders 20 years after one vaginal or one cesarean birth[J].Int Urogynecol J,2015,26(8):1115-1121.
[2]Roza TD, Mascarenhas T, Araujo M, et al. Oxford Grading Scale vs manometer for assessment of pelvic floorstrength in nulliparous sports students[J]. Physiotherapy，2013,99(3):207-211.
[3]Frawley H. Pelvic floor muscle strength testing[J]. Aust J Physiother，2006,52(4):307.
[4]DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis[J]. Am J Obstet Gynecol,1994,170(6):1713-1720.
[5]Sangsawang B.Risk factors for the development of stress urinary incontinence during pregnancy in primigravidae: a review of the literature[J]. Eur J Obstet Gynecol Reprod Biol，2014,178(6):27-34.
[6]Chen Y, Li FY, Lin X, et al. The recovery of pelvic organ support during the first year postpartum[J]. BJOG, 2013,120(11):1430-1437.
[7]Nyangoh TK, Bessede T, Zaitouna M, et al.Anatomy of the levator ani muscle and implications for obstetrics and gynaecology[J]. Gynecol Obstet Fertil，2015,43(1):84-90.
[8]Friedman S, Blomquist JL, Nugent JM, et al. Pelvic muscle strength after childbirth[J]. Obstet Gynecol，2013,121(1): 379-380.
[9]Martin-Martin S, Pascual-Fernandez A, Alvarez-Colomo C, et al. Urinary incontinence during pregnancy and postpartum. Associated risk factors and influence of pelvic floor exercises [J]. Arch Esp Urol，2014,67(4):323-330.
[10]B K, Hilde G, Tennfjord MK, et al.Does episiotomy influence vaginal resting pressure, pelvic floor muscle strength and endurance, and prevalence of urinary incontinence 6 weeks postpartum?[J] Neurourol Urodyn，2016(5),doi: 10.1002/nau.22995.
[11]Oliveira DA, Parente MP, Calvo B, et al. A biomechanical analysis on the impact of episiotomy during childbirth[J] .Biomech Model Mechanobiol，2016,15(3):1-12.
[12]Hendrix SL, Clark A, Nygaard I, et al. Pelvic organ prolapse in the Women′s Health Initiative:gravity and gravidity [J]. Am J Obstet Gynecol,2002,186(6):1160-1166.
[13]Wasserberg N, Haney M, Petrone P, et al. Morbid obesity adversely impacts pelvic floor function in females seeking attention for weight loss surgery[J]. Dis Colon Rectum,2007,50(12):2096-2103.
[14]Gozukara YM, Akalan G, Tok EC, et al. The improvement in pelvic floor symptoms with weight loss in obese women does not correlate with the changes in pelvic anatomy[J]. Int Urogynecol,2014,25(9):1219-1225.
[15]Martínez FE, Parés D, Lorente CN, et al. Urinary incontinence during pregnancy. Is there a difference between first and third trimester? [J] Eur J Obstet Gynecol Reprod Biol，2014,182(11):86-90.
[16]田丽,古丽娜·阿巴拜克力. 压力性尿失禁的流行病学及相关因素的研究进展[J]. 医学研究生学报，2011,24(1):82-86.
[17]Sangsawang B, Sangsawang N. Stress urinary incontinence in pregnant women: a reviewof prevalence, pathoph ysiology, and treatment[J].Int Urogynecol J，2013, 24(6):901-912.
[18]Alperin M, Lawley DM, Esparza MC, et al.Pregnancy-induced adaptations in the intrinsic structure of rat pelvic floor muscles[J]. Am J Obstet Gynecol，2015,213(2):191.e1-7.
[19]zdemr , Bakar Y, zengn N, et al. The effct of parity on pelvic flor muscle strength and quality of life in women with urinary incontinence: a cross sectional study[J]. J Phys Ther Sci，2015,27(7): 2133-2137.
[20]Alperin M, Cook M, Tuttle LJ, et al. Impact of vaginal parity and aging on the architecturaldesign of pelvic floor muscles[J]. Am J Obstet Gynecol，2016,215(3): 312.e1-312.e9.

相似文献/References:

[1]周岳进.妊娠期妇女慢性乙型肝炎患者核苷(酸)类似物抗病毒治疗[J].医学研究与战创伤救治(原医学研究生学报),2013,15(03):279.[doi:10.3969/j.issn.1672-271X.2013.03.023]
[2]曹艳春,范国峰.两种无创通气模式治疗妊娠合并急性心源性肺水肿的临床观察[J].医学研究与战创伤救治(原医学研究生学报),2012,14(04):336.
　CAO Yan-chun,FAN Guo-feng..Clinical observation of two models of noninvasive ventilation and oxygen in treatment of pregnant women with acute cardiogenic pulmonary edema[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2012,14(02):336.
[3]尹 英,徐 辉,毛 钊,等.口腔卫生宣教对孕妇牙周健康状况的影响[J].医学研究与战创伤救治(原医学研究生学报),2011,13(02):143.
　YIN Ying,XU Hui,MAO Zhao,et al.The effect of oral health instruction on the periodontal status of pregnant women[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(02):143.
[4]李云莉,张 秦综述,管 群,等.妊娠合并急性胰腺炎诊治分析[J].医学研究与战创伤救治(原医学研究生学报),2011,13(05):435.
[5]胡文星,车敦发,管海宏,等.妊娠合并皮肌炎1例[J].医学研究与战创伤救治(原医学研究生学报),2010,12(05):444.
[6]李彩云,张峥程,毛静月.剖宫产术同时剔除子宫肌瘤136例临床分析[J].医学研究与战创伤救治(原医学研究生学报),2010,12(06):497.
　LI Cai-yun,ZHANG Zheng-cheng,MAO Jing-yue..Clinical analysis of 136 cases of cesarean combined with myomectomy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2010,12(02):497.
[7]郑 青,刘 华,苏丽容.重型肝炎患者产后护理[J].医学研究与战创伤救治(原医学研究生学报),2010,12(01):41.
[8]朱春林,李 萍.妊娠中晚期537例心电图分析[J].医学研究与战创伤救治(原医学研究生学报),2009,11(03):243.
[9]李琪虹,周敬勉.妊娠期糖尿病并发子痫前期对脐动脉血流的影响[J].医学研究与战创伤救治(原医学研究生学报),2016,18(01):41.[doi:10.3969/j.issn.1672-271X.2016.01.012]
　LI Qi-hong,ZHOU Jing-mian..The influences of gestational diabetes complicating preeclampsiaon umbilical artery[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(02):41.[doi:10.3969/j.issn.1672-271X.2016.01.012]
[10]蔡石龙,钟志方,魏梅梅,等.临床不典型中孕期急性阑尾炎患者的超声诊断分析[J].医学研究与战创伤救治(原医学研究生学报),2018,20(02):148.[doi:10.3969/j.issn.1672-271X.2018.02.009]
　CAI Shi-long,ZHONG Zhi-fang,WEI Mei-mei,et al.Ultrasonographic diagnosis of acute appendicitis during atypical middle pregnancy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(02):148.[doi:10.3969/j.issn.1672-271X.2018.02.009]

备注/Memo

备注/Memo:
基金项目：国家科技支撑计划专项基金（2014BAI05B00）
更新日期/Last Update: 2017-03-20