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目的研究连续硬膜外分娩镇痛对初产妇产后早期盆底功能的影响。方法 200例分娩初产妇,根据分娩方式分为分娩镇痛组和无镇痛组,各100例。观察两组产妇的盆底功能指标,包括Ⅰ和Ⅱ类肌纤维的肌肉疲劳度和肌力,盆底肌静态张力、盆底肌闭合收缩力;同时比较两组盆腔脏器脱垂(POP)及压力性尿失禁(SUI)发生率,以评估产后早期盆底功能。结果两组盆底功能指标比较差异无统计学意义(P>0.05)。分娩镇痛组POP发生率为25.0%(25/100),无镇痛组为40.0%(40/100),比较差异有统计学意义(P<0.05);分娩镇痛组SUI的发生率为4.0%,无镇痛组为12.0%,比较差异有统计学意义(P<0.05)。结论分娩镇痛组盆底损伤程度比无镇痛组轻,在降低初产妇盆底功能障碍性疾病的发病率方面连续硬膜外分娩镇痛起到至关重要的作用。
Objective To study the effect of continuous epidural analgesia on early postpartum pelvic floor function of primipara. Methods 200 cases of primiparous delivery, according to mode of delivery was divided into labor analgesia group and no pain group, 100 cases each. The pelvic floor function indexes of the two groups were observed, including muscle fatigue and muscle strength of type I and II muscle fibers, static tension of pelvic floor muscle and closed contractility of pelvic floor muscles. Meanwhile, pelvic organ prolapse (POP) and Stress urinary incontinence (SUI) incidence to assess early postpartum pelvic floor function. Results There was no significant difference in pelvic floor function between the two groups (P> 0.05). The incidence of POP in childbirth analgesia group was 25.0% (25/100) and no analgesia group was 40.0% (40/100), the difference was statistically significant (P <0.05). The incidence of SUI in labor analgesia group was 4.0%, no pain control group was 12.0%, the difference was statistically significant (P <0.05). Conclusions The degree of pelvic floor injury in childbirth analgesia group is less than that in the non-analgesic group, and continuous epidural analgesia plays a crucial role in reducing the morbidity of pelvic floor dysfunction in primipara.