| 孟文颖,李小庆,王春静,等.第二产程时限对盆底功能的影响[J].安徽医药,2020,24(10):2064-2067. |
| 第二产程时限对盆底功能的影响 |
| Effect of time limit in second stage of labor on the pelvic floor function |
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| DOI：10.3969/j.issn.1009?6469.2020.10.037 |
| 中文关键词: 产程，第二 子宫收缩 骨盆底 分娩并发症 妊娠结局 产次 新产程标准 |
| 英文关键词: Labor stage,second Uterine contraction Pelvic floor Obstetric labor complications Pregnancy outcome Parity New labor standard |
| 基金项目:北京市通州区科技计划项目(KJ2016CX044) |
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| 中文摘要: |
| 目的探究新产程标准下第二程产程时限对产妇盆底功能的影响，为病人的临床治疗提供参考。方法回顾性分析北京市通州区妇幼保健院产科 2017年 3月至 2018年 3月间 978例单胎足月头先露初产妇第二产程时限，按照第二产程持续时间长短将其分为观察组 493例和对照组 485例，观察组病人在新产程标准下第二产程持续时间 ≥3 h，对照组病人第二产程持续时间≤2 h，分析两组病人产后盆底肌张力、分娩情况及盆底器官脱垂程度进行分析。结果观察组病人阴道静息压(VaginalRest Pressure，VRP)为(46.9±12.5)cmH2O、阴道收缩压(Vaginal Systolic Pressure，VSP)为(77.6±27.1)cm H2O、Ⅰ类肌纤维强度为(50.1±18.9)cmH2O，Ⅱ类肌纤维强度为(74.2±19.9)cmH2O，均明显低于对照组，持续时间明显短于对照组，两组比较差异有统计学意义(P＜0.05)；观察组病人会阴裂伤、会阴侧切、阴道助产以及产后出血发生率明显高于对照组，两组比较差异有统计学意义(P＜0.05)；观察组病人 Aa点距离为(-2.3±0.6)cm、Bb点距离为(-2.4±1.2)cm，明显大于对照组， C点距离为(-4.2±1.5) cm、Ap点距离为(-2.7±0.6)cm、Bp点距离为(-2.6±1.3)cm，D点距离为(-6.4±2.1)cm，均明显小于对照组，两组比较差异有统计学意义(P＜0.05)。结论第二产程时间的延长造成病人产后盆底肌张力降低，需严密监测，合理把控第二产程时间，预防盆底功能障碍性疾病的发生。 |
| 英文摘要: |
| Objective To explore the effect of time limit in second stage of labor under the new labor standard on the pelvic floor function of the mother，and to provide reference for the clinical treatment of the patient.Methods Nine hundred and seventy?eightprimipara who gave birth to baby with singletons full?term head presentation in the Department of Obstetrics in Tongzhou DistrictMaternal and Child Health Hospital of Beijing from March 2017 to March 2018 were retrospectively analyzed.The patients were as?signed into observation group(n＝493 cases)and control group(n＝485 cases)according to the duration of the second stage of la?bor.The duration of the second stage of labor in the observation group was ≥3h under the new labor standard，and the duration of the second stage of the control group was ≤2h.The postpartum pelvic floor muscle tension，delivery and pelvic organ prolapse of the two groups were analyzed.Results The vaginal rest pressure(VRP)［(46.9±12.5) cmH2O］， vaginal systolic pressure(VSP)［(77.6±27.1)cmH2O］class I muscle fiber strength［(50.1±18.9)cmH2O］class II muscle fiber strength［(74.2±19.9)cmH2O］in theobservationgroupwer，e significantly lower than those in the control group，a，nd the duration was significantly shorter than that in the control group(P＜0.05)； the incidence of perineal laceration，episiotomy，vaginal midwifery and postpartum hemorrhage in the observation group was significantly higher than those in the control group，and the difference between the two groups was statistical? ly significant(P＜0.05)； Aa point distance and BB point distance in the observation group was(-2.3±0.6)cm and(-2.4±1.2) cm，which were significantly larger than those of the control group；C point distance was(-4.2±1.5)cm，Ap point distance was(2.7±0.6)cm，Bp point distance was(-2.6±1.3)cm，D point distance was(-6.4±2.1)cm，which were significantly smaller than those of the control group，and the difference was statistically significant(P＜0.05).Conclusions The prolongation of the second stage of labor causes the postpartum pelvic floor muscle tension to decrease，and it is necessary to closely monitor and control thesecond stage of labor to prevent the occurrence of pelvic floor dysfunction diseases. |
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