發(fā)布時間：2018-05-15 19:49

  本文選題：初產(chǎn)婦 + 第二產(chǎn)程�。� 參考：《中國實用婦科與產(chǎn)科雜志》2017年12期

【摘要】：目的探討新產(chǎn)程標準管理下第二產(chǎn)程時長對產(chǎn)婦盆底功能的近期影響。方法回顧性分析新產(chǎn)程標準管理下2016-01-01—2016-12-31在成都市婦女兒童中心醫(yī)院陰道分娩的單胎足月頭先露活產(chǎn)初產(chǎn)婦,孕前均排除壓力性尿失禁、生殖道畸形和盆底功能障礙性疾病,孕期無嚴重內(nèi)外科合并癥和并發(fā)癥并且在年齡、孕前體重指數(shù)、孕期增重、新生兒出生體重無明顯差異者共174例,產(chǎn)程中均行硬膜外麻醉分娩鎮(zhèn)痛。A組(研究組)根據(jù)第二產(chǎn)程時長(t)分為3組:A1組(34例)2 h≤t2.5 h;A2組(20例)2.5 h≤t3 h;A3組(20例)t≥3 h。同期t2 h的產(chǎn)婦共100例作為B組(對照組)。于產(chǎn)后42 d進行問卷調(diào)查及盆底POP-Q評分分度、器官脫垂、尿失禁和綜合肌力測試,比較第二產(chǎn)程時長對女性盆底功能的影響。結(jié)果 4組在POP-Q評分Aa點(陰道前壁距處女膜3 cm點)、Ba點(陰道前壁脫出距處女膜最遠點)、C點(前穹窿或陰道殘端距處女膜點)、pb(會陰體長度)、tvl(陰道總長度)以及D點(陰道后穹窿距處女膜點)評分上差異有統(tǒng)計學意義(P0.05);進一步兩兩比較發(fā)現(xiàn):A3組在Aa、Ba、tvl、C和D點評分與另3組差異有統(tǒng)計學意義;A2、A3組在pb與另兩組差異有統(tǒng)計學意義;POP-Q分度陰道后壁脫垂A3組與另3組間差異有統(tǒng)計學意義;壓力性尿失禁發(fā)生率各組之間差異有統(tǒng)計學意義;盆底肌力A3組與另3組間差異有統(tǒng)計學意義。結(jié)論第二產(chǎn)程時長對產(chǎn)后近期盆底功能有影響,當≥3 h時會成為產(chǎn)后盆底功能障礙性疾病的高危因素。故產(chǎn)程中需嚴密監(jiān)測進展,及時處理異常因素,控制第二產(chǎn)程時長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，

本文編號：1893682