三维结合二维超声成像技术评估分娩方式对盆底结构功能的近期影响  

Short-term influence of delivery modes on pelvic structure and function evaluated by three-dimensional and two-dimensional ultrasonography

作　　者：林英姿[1] 俞波[1] 蒋伟红[1] 黄国庆[1] 高枫[1] 

机构地区：[1]杭州市第二人民医院超声科,浙江杭州310015

出　　处：《中国现代医生》2013年第1期51-53,F0003,共4页China Modern Doctor

基　　金：浙江省杭州市卫生局资助科技项目(2011A019)

摘　　要：目的研究三维和二维超声成像技术评估不同分娩方式对盆底结构功能的近期影响。方法选取我院妇产科剖腹产(剖宫组)和顺产(顺产组)妇女各100例,于产后6～8周进行三维和二维超声检查,检测静息和Val-salva状态盆隔裂孔左右径、前后径、面积、耻骨内脏肌厚度和尿道膀胱连接部移动度(UVJ-M),并进行统计分析。结果同组静息和Valsalva状态比较各观察指标差异显著(P<0.05);相同状态下顺产组的盆隔裂孔左右径、前后径、面积、耻骨内脏肌厚度、UVJ-M均大于剖宫组(P<0.05),同组相同状态左侧耻骨内脏肌厚度大于右侧(P<0.05);剖宫组尿失禁发生率较顺产组低(P<0.05)。结论阴道顺产对盆底结构和功能的损伤较剖宫组大,尿失禁发生率较剖宫组高。Objective To study the short-term influence of delivery modes on pelvic structure and function evaluated by three-dimensional and two dimensional ultrasonography. Methods Chose 200 pregnant women who received the operations of cesarean section （cesarean section group） and vaginal delivery （vaginal delivery group） from the depart- ment of gynaecology and obstetrics of this hospital, including 100 cases in each group respectively; took the three-di- mensional and two-dimensional ultrasonography 6-8 weeks after the delivery to examine the left-right diameter, an- teroposterior diameter and area of pelvic diaphragm hiatus, thickness of puborectalis muscle and urethro-vesical junc- tion mobility （UVJ-M） under the resting and Valsalva states. Results There was the significant difference in observa- tion indicators under the different states in the same group （P 〈 0.05）; under the same state, the left-right diameter, anteroposterior diameter and area of pelvic diaphragm hiatus and the thickness of puborectalis muscle and UVJ-M in the vaginal delivery group were larger than ones in the cesarean section group （P 〈 0.05）. Under the same state in the same group, the thickness of left puborectalis muscle was larger than the right one （P 〈 0.05）. Vaginal delivery group incidence of urinary incontinence was low than cesarean section group （P 〈 0.05）. Conclusion The vaginal delivery has a greater injury on pelvic structure and function than the cesarean section, with a higher incidence of incontinence of urine.

关 键 词：三维超声 二维超声 盆底结构和功能 剖宫产 阴道顺产 

分 类 号：R714.3[医药卫生—妇产科学] R445.1[医药卫生—临床医学]