椎管内分娩镇痛对初产妇盆底功能的影响

doi:10.12280/gjfckx.20220669

摘要/Abstract

摘要：

安全、有效且可控性高的分娩镇痛方式一直是麻醉科和产科医生追求的目标，椎管内分娩镇痛是首选的分娩镇痛方式，其在确保母婴安全的前提下，通过降低产妇的分娩疼痛，提高了分娩质量。与分娩有关的盆底功能障碍（pelvic floor dysfunction，PFD）是产后常见的疾病之一，主要包括压力性尿失禁、肛门括约肌损伤及女性性功能障碍等。椎管内分娩镇痛对初产妇盆底功能的影响一直是许多临床和科研工作者关注和研究的热点，其对盆底肌、肛门括约肌有保护作用，不影响盆底肌的电生理功能，可降低产后压力性尿失禁的发生率，且对产妇的性功能无不利影响。综述椎管内分娩镇痛对初产妇盆底功能的影响，为椎管内分娩镇痛技术的继续推广和初产妇PFD的防治工作提供更多的临床依据。

关键词: 镇痛, 产科, 麻醉, 硬膜外, 自然分娩, 骨盆底, 尿失禁, 压力性, 神经电生理监测

Abstract:

Safe, effective and controllable labor analgesia has been the goal pursued by anesthesiologists and obstetricians. Intraspinal labor analgesia is the first choice for labor analgesia, which improves the quality of labor by reducing labor pain while ensuring the safety of mother and infants. Pelvic floor dysfunction (PFD) associated with labor dysfunction is one of the common postpartum diseases, mainly including stress urinary incontinence, obstetrical anal sphincter injuries, female sexual dysfunction, etc. The effect of intraspinal labor analgesia on the pelvic floor function of primipara has always been the focus of attention and research by many clinical and scientific researchers. Intraspinal labor analgesia has a protective effect on the pelvic floor muscle and anal sphincter, does not affect the electrophysiological function of pelvic floor muscle, can reduce the incidence of postpartum stress urinary incontinence, and has no adverse effect on the sexual function of parturient. To summarize the effects of intraspinal labor analgesia on the pelvic floor function of primipara, so as to provide more clinical basis for the further popularization of intraspinal labor analgesia and the prevention and treatment of PFD in primipara.

Key words: Analgesia, obstetrical, Anesthesia, epidural, Natural childbirth, Pelvic floor, Urinary incontinence, stress, Neurophysiological monitoring

庞昀婷, 马庆玲, 孟凡青, 刘伟, 郭亚秋. 椎管内分娩镇痛对初产妇盆底功能的影响[J]. 国际妇产科学杂志, 2023, 50(1): 70-73.

PANG Yun-ting, MA Qing-ling, MENG Fan-qing, LIU Wei, GUO Ya-qiu. The Effect of Intraspinal Labor Analgesia on Pelvic Floor Function of Primary Parturient[J]. Journal of International Obstetrics and Gynecology, 2023, 50(1): 70-73.

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