Urogynecology and Reconstructive Pelvic Surgery, OB/Gyn & Women's Health Institute, Cleveland Clinic, Cleveland, OH.
Urogynecology and Reconstructive Pelvic Surgery, OB/Gyn & Women's Health Institute, Cleveland Clinic, Cleveland, OH.
Am J Obstet Gynecol. 2020 Jun;222(6):580.e1-580.e5. doi: 10.1016/j.ajog.2020.02.044. Epub 2020 Mar 3.
Obstetric anal sphincter injuries represent the minority of obstetric lacerations, but can have a significant long-term impact on urinary and fecal continence, as well as pelvic organ support. Accurate diagnosis of lacerations, appropriate repair, and close follow-up are essential to healthy healing and to improve outcomes for women. The infrequency of these injuries has resulted in a lack of familiarity with laceration repair and postpartum care of this population at all levels of practice. As such, continuing education strategies aimed at simulation, increased clinical exposure to anal sphincter injuries, and evidence-based repair techniques are important for mitigating the deficits in the current obstetric environment. Ensuring that patients have access to timely multidisciplinary postpartum care and education on the laceration incurred is essential to promote healthy healing and to optimize pelvic floor outcomes.
产科肛门括约肌损伤在产科裂伤中占比较小,但会对尿便控制以及盆腔器官支撑功能产生重大的长期影响。准确诊断裂伤、适当修复以及密切随访对于女性的健康愈合和改善结局至关重要。由于这些损伤较为罕见,各级医疗机构对于此类人群的裂伤修复和产后护理都缺乏熟悉度。因此,继续教育策略旨在通过模拟、增加对肛门括约肌损伤的临床接触以及基于证据的修复技术,对于减轻当前产科环境中的缺陷非常重要。确保患者能够及时获得多学科产后护理和裂伤相关教育,对于促进健康愈合和优化盆底功能结局至关重要。