北京生物医学工程

顺产过程中的盆底组织生物力学研究进展

Advances in biomechanics of pelvic floor in spontaneous labor

作者：周琳夕谷雪莲杜洪灵

单位：上海理工大学医疗器械与食品学院(上海 200093) 上海市普陀区人民医院妇产科(上海 200333)

关键词：顺产；盆底功能障碍；生物力学；易损部位；综述

分类号：R318

出版年·卷·期（页码）：2020·39·2（215-219）

摘要：

盆底功能障碍是妇科常见疾病，顺产会导致肛提肌撕脱，盆底肌肉力量减弱，这些损害严重影响产妇健康。顺产的方式、助产器械的使用都会影响顺产的进程从而造成盆底损伤，因此在顺产过程中临床医生对骨盆及其软组织损伤的判断至关重要。研究顺产盆底组织的力学变化及损伤情况，为临床医生制定康复方案提供参考是有必要的。本文主要围绕顺产对盆底的损伤及通过生物力学模拟顺产得到易损部位进行综述。

Pelvic floor dysfunction is a common gynecological disease, which can lead to the avulsion of levator ani muscle and the weakening of pelvic floor muscle strength. These damages seriously affect maternal health.The way of spontaneous delivery, the use of midwifery equipments will affect the process of spontaneous delivery, resulting in pelvic floor injury. Therefore, it is very important for clinicians to judge the pelvic and soft tissue injury in the process of delivery. It is necessary to study the mechanical changes and injuries of the pelvic floor tissue in order to provide reference for clinicians to make rehabilitation suggestions.This article mainly focuses on the pelvic floor injury caused by spontaneous labor and the vulnerable parts obtained by biomechanical simulation of spontaneous labor

参考文献：

[1] van Geelen H, Ostergard D, Sand P. A review of the impact of pregnancy and childbirth on pelvic floor function as assessed by objective measurement techniques[J]. International Urogynecology Journal, 2018, 29: 327-338.

[2] Ghi T, Dall'Asta A, Masturzo B, et al. Randomised Italian Sonography for Occiput POSition Trial Ante Vacuum (R.I.S.POS.T.A.)[J]. Ultrasound in Obstetrics & Gynecology: the official journal of the International Society of Ultrasound in Obstetrics & Gynecology, 2018, 52(6):699-705.

[3] Fitzpatrick M, Behan M, O’Connell PR, et al. Randomised clinical trial to assess anal sphincter function following forceps or vacuum assisted vaginal delivery[J]. BJOG: An International Obstetrics and Gynaecology, 2003, 110(4): 424–429.

[4] 李金凤, 赵金荣, 张林红. 孕产妇耻骨联合分离的预防及护理[J]. 临床合理用药杂志, 2012, 5(8A): 47.

[5]孟欢, 林光湖, 冯小仍, 等. 经第二骶椎髂骨翼螺钉和骶髂关节螺钉治疗C型骶髂关节脱位的有限元对比研究[J]. 中华创伤杂志, 2018, 34(6): 505-512.

Meng H, Lin GH, Feng XR, et al. Finite element comparative study of S2 alar-iliac screw and sacroiliac joint screw in treatment of type C sacroiliac joint dislocation[J]. Chinese Journal of Trauma, 2018, 34(6): 505-512.

[6] Oliveira DA, Parente MPL, Calvo B, et al. The management of episiotomy technique and its effect on pelvic floor muscles during a malposition childbirth[J]. Computer Methods in Biomechanics and Biomedical Engineering, 2017, 20(11):1249-1259.

[7] Brand?o FS, Parente MPL, Rocha PA, et al. Modeling the contraction of the pelvic floor muscles[J]. Computer Methods in Biomechanics and Biomedical Engineering, 2016, 19(4): 347-356.

[8] Sun W, Liu F, Liu S, et al. Comparison of outcomes between induction of labor and spontaneous labor for term breech - A systemic review and meta analysis[J]. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 2018, 222: 155-160.

[9] Lepage J, Jayyosi C, Lecomte-Grosbras P, et al. Biomechanical pregnant pelvic system model and numerical simulation of childbirth: impact of delivery on the uterosacral ligaments, preliminary results[J]. International Urogynecology Journal, 2015, 26: 497–504.

[10] Carroll T, Lo M, Lanteri M, et al. Zika virus preferentially replicates in the female reproductive tract after vaginal inoculation of rhesus macaques[J]. Plos Pathogens, 2017, 13(7): e1006537.

[11] Chan SS, Cheung RY, Lee LL, et al. Longitudinal follow-up of levator ani muscle avulsion: does a second delivery affect it?[J]. Ultrasound in Obstetrics & Gynecology, 2017, 50: 110-115.

[12] Mayeur O, Jeanditgautier E, Witz JF, et al. Evaluation of strains on levator ani muscle: damage induced during delivery for a prediction of patient risks[C]//Computational Biomechanics for Medicine. Cham, Switzerland: Springer International Publishing AG, 2017: 135-146.

[13] Lucente V, van Raalte H, Murphy M, et al. Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment[J]. International Journal of Womens Health, 2017, 9: 521-550.

[14] Shek KL, Chantarasorn V, Langer S, et al. Does levator trauma 'heal'?[J]. Ultrasound in Obstetrics & Gynecology: the official journal of the International Society of Ultrasound in Obstetrics & Gynecology, 2012, 40(5): 570-575.

[15] Chanda A , Unnikrishnan V. Effect of bladder and rectal loads on the vaginal canal and levator ani in varying pelvic floor conditions[J]. Mechanics of Advanced Materials and Structures, 2018, 25(14): 1214-1223.

[16] Silva MET, Brand?o S, Parente MPL, et al. The influence of pelvic organ prolapse on the passive biomechanical properties of pelvic floor muscles[J]. Journal of Mechanics in Medicine & Biology, 2017, 17(6):1750090.

[17] Baah-Dwomoh A, Alperin M, Cook M, et al. Mechanical analysis of the uterosacral ligament: swine vs. human[J]. Annals of Biomedical Engineering, 2018, 46(12): 2036-2047.

[18] Liedl B, Inoue H, Sekiguchi Y, et al. Update of the integral theory and system for management of pelvic floor dysfunction in females[J]. European Urology Supplements, 2017, 17(3): 100-108.

[19] Baah-Dwomoh A, De Vita R. Effects of repeated biaxial loads on the creep properties of cardinal ligaments[J]. Journal of the Mechanical Behavior of Biomedical Materials, 2017, 74: 128-141.

[20] Easley DC, Abramowitch SD, Moalli PA. Female pelvic floor biomechanics: bridging the gap[J]. Current Opinion in Urology, 2017, 27(3): 262-267.

[21]潘丁晨，杨碧蓉，马庆良，等.子宫脱垂的中西医治疗进展[J].中国医药导报, 2018, 15(32): 38-41.

Pan DC, Yang BR, Ma QL, et al. Progress of traditional Chinese medicine and Western medicine treatment of uterine prolapse[J].China Medical Herald, 2018, 15(32): 38-41.

服务与反馈：

【文章下载】【加入收藏】

提示：您还未登录，请登录！点此登录