摘要
撕裂伤在阴道分娩中比较常见，创伤可发生于宫颈，阴道和外阴。这些撕裂伤中，大多数不会引起功能性不良。严重的会阴撕裂伤可延伸或穿过肛门括约肌，尽管很少发生，但是一旦发生，通常会增加盆底损伤，尿便失禁，疼痛和性功能障碍的风险，并且，分娩后症状可能会持续数年。本文的目的是为会阴撕裂伤的预防、识别，以及产科修复术和会阴切开术提供循证指南。
EffectofEpisiotomyandPerinealTraumaonPelvicFloorFunction
会阴切开术及会阴创伤对骨盆底功能的影响
Separatingtheuniquecontributionsofvaginalbirth,operativevaginaldelivery,episiotomy,andOASIStopelvicfloorfunctionisachallenge.Womenmayexperiencemorethanoneriskfactoratdeliveryandmanyexposuresareinterrelated.Asystematicreviewof26articlesfoundthataroutineepisiotomyofferednoimmediateorlong-termmaternalbenefitinperineallacerationseverity,pelvicfloordysfunction(includingurinaryorfecalincontinence),orpelvicorganprolapseoverarestrictiveuseofepisiotomy(13).Inotherreviews,however,episiotomyhasbeenassociatedwithincreasedriskofpostpartumanalincontinence.Inameta-analysisincludingeightstudies,episiotomywasassociatedwithanincreasedriskofanalincontinence(pooledoddsratio[OR],1.74;95%confidenceinterval[CI],1.28–2.38)中药治疗白癜风白癜风治的好吗
