会阴侧切对初产妇产后阴道收缩力和性生活的影响分析
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摘要
目的探讨会阴侧切对初产妇产后阴道收缩力和性生活的影响。方法选取2015年5月至2017年1月在枣阳市第一人民医院分娩的102例初产妇为研究对象,根据不同分娩方式将其分为观察组和对照组,每组51例初产妇。观察组初产妇于分娩时行会阴侧切术,对照组初产妇行常规阴道分娩,观察两组初产妇产后阴道收缩力、性功能和性生活变化。结果产后1个月、3个月和6个月,两组初产妇阴道收缩力均呈明显递增(均P<0.05),两组初产妇阴道收缩力差异均无统计学意义(均P>0.05)。产后1个月、3个月和6个月,两组初产妇FSFI评分均呈明显递增(均P<0.05);观察组初产妇的FSFI评分均低于对照组初产妇,其差异均具有统计学意义(均P<0.05)。产后1个月,两组初产妇性生活恢复和性生活疼痛情况差异均无统计学意义(均P>0.05)。产后3个月、6个月,对照组初产妇性生活恢复率分别为64.7%和84.3%,显著高于观察组初产妇的43.1%和66.7%;对照组初产妇性生活疼痛的发生率分别为33.3%和15.7%,明显低于观察组初产妇的52.9%和35.3%,其差异均具有统计学意义(均P<0.05)。结论会阴侧切对初产妇产后阴道收缩力恢复无明显影响,可以引起产后性功能下降,不利于性生活恢复,因此应当尽量限制其应用。
Objective To investigate the effect of lateral episiotomy on the postpartum vaginal contractility and sexual life of primipara. Methods 102 primiparous women delivered in Zaoyang the First People′s Hospital from May 2015 to January 2017 were divided into observation group(51 cases) and control group(51 cases) according to different delivery methods. The observation group received lateral episiotomy and conventional vaginal delivery was adopted in the control group. Changes in postpartum vaginal contractility, sexual function and sexual life were observed in the two groups. Results The vaginal contractility of the two groups was significantly increased(all P<0.05) at the first, third and sixth month after delivery, without statistically significant difference between the two groups. The FSFI score of the two groups was significantly increased at the first, third and sixth month after delivery(all P<0.05), and the FSFI scores of the observation group were significantly lower than these in the control group, with statistically significant differences(all P<0.05). There was no significant difference in the recovery of sexual life and sexual life pain between the two groups at the first month after delivery(all P>0.05). The recovery rate of sexual life was 64.7% and 84.3% in the control group at the third and sixth month after delivery respectively, which was significantly higher than that in the observation group of 43.1% and 66.7%, with statistically significant difference(P<0.05). The incidence of sexual life pain was 33.3% and 15.7% in the control group at the third and sixth month respectively, which was significantly lower than that in the observation group of 52.9% and 35.3%, with statistically significant difference(P<0.05). Conclusions Lateral episiotomy has no obvious effect on the recovery of postpartum vaginal contractility, but can cause postpartum sexual function decline, which is not conducive to the recovery of sexual life, so its application should be limited in clinical.
Objective To investigate the effect of lateral episiotomy on the postpartum vaginal contractility and sexual life of primipara. Methods 102 primiparous women delivered in Zaoyang the First People′s Hospital from May 2015 to January 2017 were divided into observation group(51 cases) and control group(51 cases) according to different delivery methods. The observation group received lateral episiotomy and conventional vaginal delivery was adopted in the control group. Changes in postpartum vaginal contractility, sexual function and sexual life were observed in the two groups. Results The vaginal contractility of the two groups was significantly increased(all P<0.05) at the first, third and sixth month after delivery, without statistically significant difference between the two groups. The FSFI score of the two groups was significantly increased at the first, third and sixth month after delivery(all P<0.05), and the FSFI scores of the observation group were significantly lower than these in the control group, with statistically significant differences(all P<0.05). There was no significant difference in the recovery of sexual life and sexual life pain between the two groups at the first month after delivery(all P>0.05). The recovery rate of sexual life was 64.7% and 84.3% in the control group at the third and sixth month after delivery respectively, which was significantly higher than that in the observation group of 43.1% and 66.7%, with statistically significant difference(P<0.05). The incidence of sexual life pain was 33.3% and 15.7% in the control group at the third and sixth month respectively, which was significantly lower than that in the observation group of 52.9% and 35.3%, with statistically significant difference(P<0.05). Conclusions Lateral episiotomy has no obvious effect on the recovery of postpartum vaginal contractility, but can cause postpartum sexual function decline, which is not conducive to the recovery of sexual life, so its application should be limited in clinical.
引文
[1] 郭仁妃,王爱宝,张宏玉,等.不同分娩方式对初产妇产后阴道收缩力及性生活的影响[J].护理学杂志,2014,29(18):43-45.
[2] 彭海燕,刘瑞景,白一婷,等.常规会阴侧切对产后女性盆底功能的近期影响[J].河北医药,2017,39(1):138-139,142.
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[4] Karbanova J,Rusavy Z,Betincova L.et al.Clinical evaluation of peripartum outcomes of mediolateral versus lateral episiotomy[J].International Journal of Gynecology and Obstetrics,2014,124(1):72-76.
[5] 凌奇.会阴侧切对初产妇产后盆底功能影响的临床研究[J].临床和实验医学杂志,2015,14(24):2070-2072.
[6] 胡方方,张艺凡,崔海涛,等.会阴侧切对初产妇产后早期盆底康复疗效的影响[J].中华实用诊断与治疗杂志,2017,31(6):568-570.
[7] R?is?nen S,Vehvil?inen-Julkunen K,Gissler M,et al.Hospital-based lateral episiotomy and obstetric anal sphincter injury rates:A retrospective population-based register study[J].American Journal of Obstetrics and Gynecology,2012,206(4):347,e1-6.
[8] Karbanova J,Rusavy Z,Betincova L,et al.Clinical evaluation of early postpartum pain and healing outcomes after mediolateral versus lateral episiotomy[J].International Journal of Gynecology and Obstetrics,2014,127(2):152-156.
[9] Rusavy Z,Karbanova J,Jansova M,et al.Anal incontinence and sexuality after mediolateral and lateral episiotomy:A randomized controlled trial[J].International Urogynecology Journal and Pelvic Floor Dysfunction,2015,26(Suppl 1):S39-S40.
[10] 叶兆兰,张轶兰,彭继蓉,等.改良助产方式对降低阴道分娩会阴侧切率的效果观察[J].中国妇幼健康研究,2016,27(9):1131-1133.
[11] Faisal-Cury A,Huang H,Chan Y-F,et al.The relationship between depressive/anxiety symptoms during pregnancy/postpartum and sexual life decline after delivery[J].The Journal of Sexual Medicine,2013,10(5):1343-1349.
[12] Nappi RE.Counseling on vaginal delivery of contraceptive hormones:Implications for women′s body knowledge and sexual health[J].Gynecological Endocrinology,2013,29(12):1015-1021.
[13] Imhoff LR,Brown JS,Creasman JM,et al.Fecal incontinence decreases sexual quality of life,but does not prevent sexual activity in women[J].Diseases of the Colon and Rectum,2012,55(10):1059-1065.
[14] Sadler AG,Mengeling MA,Fraley SS,et al.Correlates of sexual functioning in women veterans:Mental health,gynecologic health,health status,and sexual assault history[J].International Journal of Sexual Health,2012,24(1):60-77.
[15] Badran M,Taha E,Tayel M,et al.Ultra-fine self nanoemulsifying drug delivery system for transdermal delivery of meloxicam:Dependency on the type of surfactants[J].Journal of Molecular Liquids,2014,190:16-22.
[16] Kalis V,Laine K,DeLeeuw JW,et al.Classification of episiotomy:Towards a standardisation of terminology[J].BJOG,2012,119(5):522-526.
[17] 朱惠娟,卓丽英,龙翠萍,等.会阴侧切对初产妇盆底功能的近期影响[J].现代诊断与治疗,2016,27(16):3040-3042.
[18] 李华,凌艳姣.分娩会阴侧切和自然裂伤与盆底功能的相关性[J].中国妇幼健康研究,2015,26(1):78-80.
[2] 彭海燕,刘瑞景,白一婷,等.常规会阴侧切对产后女性盆底功能的近期影响[J].河北医药,2017,39(1):138-139,142.
[3] Fodstad K,Laine K,Staff AC,et al.Different episiotomy techniques,postpartum perineal pain,and blood loss:An observational study[J].International Urogynecology Journal,2013,24(5):865-872.
[4] Karbanova J,Rusavy Z,Betincova L.et al.Clinical evaluation of peripartum outcomes of mediolateral versus lateral episiotomy[J].International Journal of Gynecology and Obstetrics,2014,124(1):72-76.
[5] 凌奇.会阴侧切对初产妇产后盆底功能影响的临床研究[J].临床和实验医学杂志,2015,14(24):2070-2072.
[6] 胡方方,张艺凡,崔海涛,等.会阴侧切对初产妇产后早期盆底康复疗效的影响[J].中华实用诊断与治疗杂志,2017,31(6):568-570.
[7] R?is?nen S,Vehvil?inen-Julkunen K,Gissler M,et al.Hospital-based lateral episiotomy and obstetric anal sphincter injury rates:A retrospective population-based register study[J].American Journal of Obstetrics and Gynecology,2012,206(4):347,e1-6.
[8] Karbanova J,Rusavy Z,Betincova L,et al.Clinical evaluation of early postpartum pain and healing outcomes after mediolateral versus lateral episiotomy[J].International Journal of Gynecology and Obstetrics,2014,127(2):152-156.
[9] Rusavy Z,Karbanova J,Jansova M,et al.Anal incontinence and sexuality after mediolateral and lateral episiotomy:A randomized controlled trial[J].International Urogynecology Journal and Pelvic Floor Dysfunction,2015,26(Suppl 1):S39-S40.
[10] 叶兆兰,张轶兰,彭继蓉,等.改良助产方式对降低阴道分娩会阴侧切率的效果观察[J].中国妇幼健康研究,2016,27(9):1131-1133.
[11] Faisal-Cury A,Huang H,Chan Y-F,et al.The relationship between depressive/anxiety symptoms during pregnancy/postpartum and sexual life decline after delivery[J].The Journal of Sexual Medicine,2013,10(5):1343-1349.
[12] Nappi RE.Counseling on vaginal delivery of contraceptive hormones:Implications for women′s body knowledge and sexual health[J].Gynecological Endocrinology,2013,29(12):1015-1021.
[13] Imhoff LR,Brown JS,Creasman JM,et al.Fecal incontinence decreases sexual quality of life,but does not prevent sexual activity in women[J].Diseases of the Colon and Rectum,2012,55(10):1059-1065.
[14] Sadler AG,Mengeling MA,Fraley SS,et al.Correlates of sexual functioning in women veterans:Mental health,gynecologic health,health status,and sexual assault history[J].International Journal of Sexual Health,2012,24(1):60-77.
[15] Badran M,Taha E,Tayel M,et al.Ultra-fine self nanoemulsifying drug delivery system for transdermal delivery of meloxicam:Dependency on the type of surfactants[J].Journal of Molecular Liquids,2014,190:16-22.
[16] Kalis V,Laine K,DeLeeuw JW,et al.Classification of episiotomy:Towards a standardisation of terminology[J].BJOG,2012,119(5):522-526.
[17] 朱惠娟,卓丽英,龙翠萍,等.会阴侧切对初产妇盆底功能的近期影响[J].现代诊断与治疗,2016,27(16):3040-3042.
[18] 李华,凌艳姣.分娩会阴侧切和自然裂伤与盆底功能的相关性[J].中国妇幼健康研究,2015,26(1):78-80.