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目的探讨第二产程时间对分娩镇痛产妇盆底功能的影响。方法选取钦州市第一人民医院2015年7月—2016年10月收治的分娩镇痛产妇108例,以第二产程时间<2 h为观察A组(n=62),以第二产程时间为2~<3 h为观察B组(n=46)。两组产妇均予以分娩镇痛及盆底肌力检查,比较两组产妇压力型尿失禁(SUI)、盆腔器官脱垂(POP)发生率及Ⅰ、Ⅱ类肌纤维情况。结果观察B组POP、SUI发生率高于观察组A(P<0.05)。观察B组Ⅰ类肌纤维肌力损伤率、疲劳度高于观察A组,阴道压力低于观察A组(P<0.05)。两组产妇Ⅱ类肌纤维肌力损伤率比较,差异无统计学意义(P>0.05);观察B组Ⅱ类肌纤维疲劳度高于观察A组,阴道压力低于观察A组(P<0.05)。结论延长第二产程可提高分娩镇痛产妇POP、SUI发生率,可对Ⅰ类肌纤维肌力、疲劳度、阴道压力造成不利影响,提高PFD发生率。
Objective To investigate the effect of second stage labor on pelvic floor function in labor analgesia. Methods 108 cases of labor analgesia from July 2015 to October 2016 in Qinzhou First People’s Hospital were selected. The second stage of labor was less than 2 hours and the second stage of labor was 2 ~ <3 h for the observation group B (n = 46). The two groups of women were given labor analgesia and pelvic floor muscle examination, compared two groups of maternal pressure urinary incontinence (SUI), pelvic organ prolapse (POP) incidence and type Ⅰ, Ⅱ myofibers. Results The incidence of POP and SUI in group B was higher than that in group A (P <0.05). The muscle injury rate and the fatigue degree of group Ⅰ muscle fibers were observed. The pressure of vagina was lower than that of observation group A (P <0.05). There was no significant difference in muscle damage between the two groups of maternal fibrosis fibers (P> 0.05). The degree of fatigue of group Ⅱ muscle fiber in observation group B was higher than that in observation group A, and the vaginal pressure was lower than that in observation group A (P <0.05). Conclusions Prolongation of the second stage of labor can increase the incidence of POP and SUI in labor analgesia, which may adversely affect the strength, fatigue and vaginal pressure of type Ⅰ myofibers and increase the incidence of PFD.