山东医药
山東醫藥
산동의약
Shandong Medical Journal
2015年
43期
11-13
,共3页
刘浏%张妤%卫兵%王文艳
劉瀏%張妤%衛兵%王文豔
류류%장여%위병%왕문염
盆底肌%盆底功能障碍性疾病%盆底肌表面肌电信号%产妇%分娩方式
盆底肌%盆底功能障礙性疾病%盆底肌錶麵肌電信號%產婦%分娩方式
분저기%분저공능장애성질병%분저기표면기전신호%산부%분면방식
pelvic floor muscle%pelvic floor dysfunction%surface electromyography of pelvic floor muscle%postpartum women%delivery mode
目的：了解产后妇女盆底肌力与分娩方式、季节的关系。方法选择2013年12月~2014年11月安徽医科大学第二附属医院收治的足月妊娠分娩、产后6周复查产妇902例作为研究对象,其中剖宫产410例(剖宫产组)、经阴分娩492例(顺产组)。所有产妇在产后接受盆底肌力检查(受检时间为产后35~118 d,于春、夏、秋、冬季接受盆底肌力检查者分别为191、231、233、247例),采用Glazer评估法评估其盆底肌表面肌电压。结果盆底肌肉的5次快速收缩最大肌电压(Dmax)剖宫产组为(37.01±15.65)μV、顺产组为(31.98±12.56)μV,两组相比,t=-5.359,P<0.01。盆底肌持续收缩60 s的平均肌电压(H60 s)剖宫产组为(21.74±10.71)μV、顺产组为(19.06±8.87)μV,两组相比,t=-4.119,P<0.01。春、夏、秋、冬季接受盆底肌力检查者的Dmax分别为(35.99±11.10)、(34.10±13.00)、(33.45±16.86)、(33.86±14.85)μV,组间相比,F=1.256, P>0.05。春、夏、秋、冬季接受盆底肌力检查者的H60 s分别为(24.87±8.82)、(20.74±8.83)、(17.89±10.33)、(18.55±9.77)μV,组间相比,F=22.721,P<0.01；春、夏季接受检查者的H60 s均明显高于秋季检查者(t分别为7.386、3.193,P均<0.01)。分别以Dmax、H60 s为应变量,以孕次、分娩方式、受检季节为自变量,建立多元线性回归模型,分析显示,分娩方式与Dmax、H60 s有关(P均<0.01),受检季节与H60 s有关(P<0.01)。结论产后妇女盆底肌肌力与分娩方式有关,剖宫产产妇的盆底肌力较顺产者高；产后妇女盆底肌持续收缩力与受检季节有关,春、夏季比较高。
目的：瞭解產後婦女盆底肌力與分娩方式、季節的關繫。方法選擇2013年12月~2014年11月安徽醫科大學第二附屬醫院收治的足月妊娠分娩、產後6週複查產婦902例作為研究對象,其中剖宮產410例(剖宮產組)、經陰分娩492例(順產組)。所有產婦在產後接受盆底肌力檢查(受檢時間為產後35~118 d,于春、夏、鞦、鼕季接受盆底肌力檢查者分彆為191、231、233、247例),採用Glazer評估法評估其盆底肌錶麵肌電壓。結果盆底肌肉的5次快速收縮最大肌電壓(Dmax)剖宮產組為(37.01±15.65)μV、順產組為(31.98±12.56)μV,兩組相比,t=-5.359,P<0.01。盆底肌持續收縮60 s的平均肌電壓(H60 s)剖宮產組為(21.74±10.71)μV、順產組為(19.06±8.87)μV,兩組相比,t=-4.119,P<0.01。春、夏、鞦、鼕季接受盆底肌力檢查者的Dmax分彆為(35.99±11.10)、(34.10±13.00)、(33.45±16.86)、(33.86±14.85)μV,組間相比,F=1.256, P>0.05。春、夏、鞦、鼕季接受盆底肌力檢查者的H60 s分彆為(24.87±8.82)、(20.74±8.83)、(17.89±10.33)、(18.55±9.77)μV,組間相比,F=22.721,P<0.01；春、夏季接受檢查者的H60 s均明顯高于鞦季檢查者(t分彆為7.386、3.193,P均<0.01)。分彆以Dmax、H60 s為應變量,以孕次、分娩方式、受檢季節為自變量,建立多元線性迴歸模型,分析顯示,分娩方式與Dmax、H60 s有關(P均<0.01),受檢季節與H60 s有關(P<0.01)。結論產後婦女盆底肌肌力與分娩方式有關,剖宮產產婦的盆底肌力較順產者高；產後婦女盆底肌持續收縮力與受檢季節有關,春、夏季比較高。
목적：료해산후부녀분저기력여분면방식、계절적관계。방법선택2013년12월~2014년11월안휘의과대학제이부속의원수치적족월임신분면、산후6주복사산부902례작위연구대상,기중부궁산410례(부궁산조)、경음분면492례(순산조)。소유산부재산후접수분저기력검사(수검시간위산후35~118 d,우춘、하、추、동계접수분저기력검사자분별위191、231、233、247례),채용Glazer평고법평고기분저기표면기전압。결과분저기육적5차쾌속수축최대기전압(Dmax)부궁산조위(37.01±15.65)μV、순산조위(31.98±12.56)μV,량조상비,t=-5.359,P<0.01。분저기지속수축60 s적평균기전압(H60 s)부궁산조위(21.74±10.71)μV、순산조위(19.06±8.87)μV,량조상비,t=-4.119,P<0.01。춘、하、추、동계접수분저기력검사자적Dmax분별위(35.99±11.10)、(34.10±13.00)、(33.45±16.86)、(33.86±14.85)μV,조간상비,F=1.256, P>0.05。춘、하、추、동계접수분저기력검사자적H60 s분별위(24.87±8.82)、(20.74±8.83)、(17.89±10.33)、(18.55±9.77)μV,조간상비,F=22.721,P<0.01；춘、하계접수검사자적H60 s균명현고우추계검사자(t분별위7.386、3.193,P균<0.01)。분별이Dmax、H60 s위응변량,이잉차、분면방식、수검계절위자변량,건립다원선성회귀모형,분석현시,분면방식여Dmax、H60 s유관(P균<0.01),수검계절여H60 s유관(P<0.01)。결론산후부녀분저기기력여분면방식유관,부궁산산부적분저기력교순산자고；산후부녀분저기지속수축력여수검계절유관,춘、하계비교고。
Objective To investigate the relationship between delivery mode, delivery season and postnatal pelvic floor muscle strength. Methods A total of 902 postpartum women, including 410 cases of cesarean delivery ( cesarean delivery group) and 492 cases of spontaneous delivery ( spontaneous delivery group) , were screened for pelvic floor muscle strength after childbirth. The pelvic floor muscle strength of all eligible pregnant women was measured, and the measure time was from 35 to 118 days postpartum. There were 191 cases of pregnant women in the spring, 231 in the summer, 233 in the autumn and 247 in the winter. Glazer protocol was used to measure surface muscle voltage of pelvic floor muscle. Results The maximum muscle voltage of pelvic floor muscle in 5 times of fast-contracting (Dmax) was (37. 01 ± 15. 65)μV in the cesarean delivery group, and (31. 98 ± 12. 56) μV in the spontaneous delivery group, and there was significant difference between these two groups(P <0. 01). The mean value of 60 s continuous contraction of pelvic floor muscles (H60 s) was (21. 74 ± 10. 71) μV in the cesarean delivery group, and (19. 06 ± 8. 87) μV in the spontaneous delivery group, and there was significant difference between these two groups(P<0. 01). The mean value of Dmax was(35. 99 ± 11. 10)μV among pregnant women in the spring,(34. 10 ± 13. 00) μV in the summer, (33. 45 ± 16. 86)μV in the au-tumn, and (33. 86 ± 14. 85)μV in the winter, and there was no significant difference among these groups (F=1. 256, P>0. 05). The mean value of H60 s was (24. 87 ± 8. 82) μV among pregnant women in the spring, (20. 74 ± 8. 83)μV in the summer, (17. 89 ± 10. 33)μV in the autumn and (18. 55 ± 9. 77)μV in the winter, and there was significant differ-ence among these groups (F=22. 721, P<0. 01). The mean value of H60 s of the women in the spring and summer was sig-nificant higher than that in the autumn(t=7. 386, 3. 193;all P<0. 01). If we took Dmax, H60 s, gravidity, delivery mode and the delivery seasons as the independent variable to make the multiple liner regression models, it showed that the deliv-ery mode was related with Dmax and H60 s(P<0. 01), and the delivery season was related with H60 s(P<0. 01). Conclu-sions The postnatal pelvic floor muscle strength is statistically related with delivery mode, and the postnatal pelvic floor muscle strength is higher in women with cesarean delivery than that with spontaneous delivery. The continuous contraction of pelvic floor muscles is related with the delivery season, which is high in the spring and summer.
