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硬膜外镇痛对自然分娩后盆底功能的影响:一项纵向回顾性研究。

Effects of epidural analgesia on pelvic floor function after spontaneous delivery: a longitudinal retrospective study.

作者信息

Meyer S, Achtari C, Hohlfeld P, De Grandi P, Buchser E

机构信息

Urogynecology Unit, Department of Gynecology and Obstetrics, CHUV, Lausanne, Switzerland.

出版信息

Int Urogynecol J Pelvic Floor Dysfunct. 2002 Nov;13(6):359-64; discussion 364-5. doi: 10.1007/s001920200080.

Abstract

The aim of the study was to assess the effects of epidural analgesia on pelvic floor function. Eighty-two primiparous women (group 1, consisting of 41 given an epidural, and group 2 of 41 not given an epidural) were investigated during pregnancy and at 2 and 10 months after delivery by a questionnaire, clinical examination, and assessment of bladder neck behavior, urethral sphincter function and intravaginal/intra-anal pressures. The prevalence of stress urinary incontinence was similar in both groups at 2 months (24% vs. 17%, P = 0.6) and 10 months (22% vs. 7%, P = 0.1), as was the prevalence of decreased sexual vaginal response at 10 months (27% vs. 10%, P = 0.08). Bladder neck behavior, urethral sphincter function and intravaginal and intra-anal pressures showed no significant differences between the two groups. Ten months after spontaneous delivery, there were no significant differences in the prevalence of stress urinary incontinence and decreased sexual vaginal response, or in bladder neck behavior, urethral sphincter function and pelvic floor muscle strength between women who had or had not had epidural analgesia.

摘要

该研究的目的是评估硬膜外镇痛对盆底功能的影响。研究人员通过问卷调查、临床检查以及对膀胱颈行为、尿道括约肌功能和阴道内/肛门内压力的评估,对82名初产妇进行了研究(第1组由41名接受硬膜外镇痛的产妇组成,第2组由41名未接受硬膜外镇痛的产妇组成),调查时间为孕期以及产后2个月和10个月。两组在产后2个月(24% 对 17%,P = 0.6)和10个月时压力性尿失禁的发生率相似(22% 对 7%,P = 0.1),在产后10个月时阴道性反应降低的发生率也相似(27% 对 10%,P = 0.08)。两组在膀胱颈行为、尿道括约肌功能以及阴道内和肛门内压力方面均无显著差异。自然分娩10个月后,接受或未接受硬膜外镇痛的女性在压力性尿失禁发生率、阴道性反应降低发生率,以及膀胱颈行为、尿道括约肌功能和盆底肌肉力量方面均无显著差异。

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