三维超声评价不同分娩方式对产后肛提肌裂孔的影响  

Effects of different delivery modes evaluated by three-dimensional ultrasound on levator hiatus after postpartum

作　　者：农美芬[1] 凌冰[1] 陈海宁[1] 王小燕[1] 廖明珠[1] 

机构地区：[1]广西壮族自治区人民医院超声科,南宁530021

出　　处：《中国临床新医学》2015年第10期910-913,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西卫计委科研课题(编号:Z2012310)

摘　　要：目的探讨应用会阴三维超声评估不同分娩方式对产后肛提肌裂孔的大小形态改变的影响。方法收集2013-12～2014-12产科分娩后42～45d的产妇65例，其中选择性剖宫产组30例，阴道顺产组35例。另选择25例未生育妇女作为对照组，经会阴三维超声分别采集静息期和Valsalva期的图像，观察不同状态下肛提肌裂孔的形态改变，并测量裂孔的形态学参数。结果两种不同状态下，顺产组和选择性剖宫产组肛提肌裂孔的左右径、前后径和面积各径线的测值均大于对照组，左右侧耻骨直肠肌的厚度小于对照组，差异均有统计学意义（P〈0．05）；顺产组肛提肌裂孔的左右径、前后径和面积各径线的测值均大于选择性剖宫产组，左右耻骨直肠肌的厚度小于剖宫产组，差异均有统计学意义（P〈0．05）。结论产后女性肛提肌裂孔增大，肛提肌变薄，经阴道分娩者大于选择性剖宫产者；经会阴盆底三维超声检查可有效显示产后肛提肌裂孔情况。Objective To investigate the changes in the size and shape of the levator hiatus in postpartum women with different delivery methods by transperineal three-dimensional ultrasound( 3D). Methods Sixty-five postpartum women after 42 ~ 45 days postpartum between December 2013 and December 2014 were included in this study,with 30 cases in the cesarean group and 35 cases in the normal delivery group. 25 cases of nulliparous women were included in the control group. The images of rest phase and Valsalva phase were collected. The changes in the size and shape of the levator hiatus of the two phases were observed,and the morphological parameters were measured.Results In the rest phase and Valsalva phase,the transversal diameter,anteroposterior diameter and areas in both of the cesarean group and the normal delivery group were significantly greater than those in the control group. The thicknesses of the bilateral puborectalis of the above two groups were significantly smaller than those of the control group( P < 0. 05). The transversal diameter,anteroposterior diameter and area of the normal delivery group were greater than those of the cesarean group,and the thickness of the bilateral puborectalis of the normal delivery group was significantly smaller than that of the cesarean group( P < 0. 05). Conclusion Levator hiatus becomes bigger and lavatory ani muscle becomes thinner in a postpartum woman than those in a nulliparous woman. Levator hiatus becomes bigger and lavatory ani muscle becomes thinner in a normal delivery woman than those in a cesarean woman.Transperineal 3D ultrasound is an effective imaging method for showing levator hiatus in postpartum women.

关 键 词：三维超声 肛提肌裂孔 产后 

分 类 号：R445.1[医药卫生—影像医学与核医学]