The effect of intraspinal blocking analgesia on delivery quality and puerperal pelvic floor function of primipara
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目的 探讨椎管内阻滞镇痛对初产妇分娩质量、产后盆底功能的影响。 方法 回顾性选择2021年1月至2022年4月在芜湖市第二人民医院分娩的99例初产妇为研究对象，其中54例采用椎管内阻滞镇痛（研究组），45例采用常规镇痛，未接受椎管内阻滞（对照组），比较两组分娩质量，产后6~8周应用盆底康复治疗仪、盆底超声评价盆底功能情况并进行比较。 结果 两组均顺利阴道分娩，研究组总产程时间长于对照组[（8.03 ± 2.94）h比（6.89 ± 3.49）h]，差异有统计学意义（P<0.05）。研究组产后6~8周盆底快速收缩阶段最大值、快速收缩阶段上升时间、持续收缩阶段平均值均大于对照组[（32.85 ± 10.13）μV比（14.73 ± 3.25）μV、（0.28 ± 0.06）s比（0.22 ± 0.05）s、（30.26 ± 5.24）μV比（16.74 ± 4.00）μV]，差异有统计学意义（P<0.05）；两组前静息阶段、快速收缩阶段恢复时间、后静息阶段比较差异无统计学意义（P>0.05）。研究组产后6~8周盆底Ⅰ、Ⅱ类肌异常率低于对照组，但差异无统计学意义（P>0.05）。研究组产后最大Valsalva状态下肛提肌裂孔面积、最大Valsalva状态下膀胱尿道后角、静息状态下肛提肌裂孔面积、膀胱颈移动度均小于对照组[（19.09 ± 4.82）cm2比（23.00 ± 5.34）cm2、（138.59 ± 23.14）°比（148.47 ± 20.38）°、（9.96 ± 2.63）cm2比（11.60 ± 2.75）cm2、（20.13 ± 4.37）mm比（28.05 ± 6.52）mm]，差异有统计学意义（P<0.05）。 结论 椎管内阻滞镇痛虽会延长初产妇总产程时间，但可减轻对盆底功能的损伤，可能是通过增多收缩阶段以保护盆底肌。 Objective To explore the effects of intraspinal blocking analgesia on the delivery quality and puerperal pelvic floor function of primiparas. Methods A total of 99 primiparas who delivered in the Second People′s Hospital of Wuhu City from January 2021 to April 2022 were enrolled in this study, 54 patients received intraspinal blocking analgesia (study group) and 45 patients received conventional treatment, without intraspinal blocking analgesia (control group). The delivery quality between the two groups was compared, and the pelvic floor function was evaluated and compared by pelvic floor rehabilitation therapy instrument and pelvic floor ultrasound at 6-8 weeks after delivery. Results Vaginal delivery were successful in both groups. The total labor duration in the study group was longer than that in the control group: (8.03 ± 2.94) h vs. (6.89 ± 3.49) h, there was statistical difference (P<0.05). The maximum value of pelvic floor rapid contraction stage, rising time and average value of continuous contraction stage in the study group were higher than those in the control group: (32.85 ± 10.13) μV vs. (14.73 ± 3.25) μV, (0.28 ± 0.06) s vs. (0.22 ± 0.05) s, (30.26 ± 5.24) μV vs. (16.74 ± 4.00) μV, there were statistical differences (P<0.05). There were no statistical differences in other indicators such as the pre-resting stage, rapid contraction phase recovery time and post-resting stage between the two groups (P>0.05). The rate of pelvic floor class Ⅰ and class Ⅱ muscle abnormalities at 6-8 weeks after delivery in the study group were lower than those in the control group, but there were no statistical differences (P>0.05). The maximum Valsalva state hiatus area of levator ani muscle, maximum Valsalva state bladder posterior urethral angle, hiatus area of levator ani muscle at rest state and bladder neck degree in the study group were smaller than those in the control group: (19.09 ± 4.82) cm2 vs. (23.00 ± 5.34) cm2, (138.59 ± 23.14)° vs. (148.47 ± 20.38)°, (9.96 ± 2.63) cm2 vs. (11.60 ± 2.75) cm2, (20.13 ± 4.37) mm vs. (28.05 ± 6.52) mm, there were statistical differences (P<0.05). Conclusions Although intraspinal block analgesia can prolong the total labor time of primipara, but it can reduce the damage of pelvic floor function, possibly by increasing systolic period to protect pelvic floor muscles.
Objective To explore the effects of intraspinal blocking analgesia on the delivery quality and puerperal pelvic floor function of primiparas. Methods A total of 99 primiparas who delivered in the Second People′s Hospital of Wuhu City from January 2021 to April 2022 were enrolled in this study, 54 patients received intraspinal blocking analgesia (study group) and 45 patients received conventional treatment, without intraspinal blocking analgesia (control group). The delivery quality between the two groups was compared, and the pelvic floor function was evaluated and compared by pelvic floor rehabilitation therapy instrument and pelvic floor ultrasound at 6-8 weeks after delivery. Results Vaginal delivery were successful in both groups. The total labor duration in the study group was longer than that in the control group: (8.03 ± 2.94) h vs. (6.89 ± 3.49) h, there was statistical difference (P<0.05). The maximum value of pelvic floor rapid contraction stage, rising time and average value of continuous contraction stage in the study group were higher than those in the control group: (32.85 ± 10.13) μV vs. (14.73 ± 3.25) μV, (0.28 ± 0.06) s vs. (0.22 ± 0.05) s, (30.26 ± 5.24) μV vs. (16.74 ± 4.00) μV, there were statistical differences (P<0.05). There were no statistical differences in other indicators such as the pre-resting stage, rapid contraction phase recovery time and post-resting stage between the two groups (P>0.05). The rate of pelvic floor class Ⅰ and class Ⅱ muscle abnormalities at 6-8 weeks after delivery in the study group were lower than those in the control group, but there were no statistical differences (P>0.05). The maximum Valsalva state hiatus area of levator ani muscle, maximum Valsalva state bladder posterior urethral angle, hiatus area of levator ani muscle at rest state and bladder neck degree in the study group were smaller than those in the control group: (19.09 ± 4.82) cm2 vs. (23.00 ± 5.34) cm2, (138.59 ± 23.14)° vs. (148.47 ± 20.38)°, (9.96 ± 2.63) cm2 vs. (11.60 ± 2.75) cm2, (20.13 ± 4.37) mm vs. (28.05 ± 6.52) mm, there were statistical differences (P<0.05). Conclusions Although intraspinal block analgesia can prolong the total labor time of primipara, but it can reduce the damage of pelvic floor function, possibly by increasing systolic period to protect pelvic floor muscles.
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