经会阴超声研究产钳助产对女性盆底的短期及中长期影响  

Study on the Short Term and Mid-long Term Effects of Forceps Assisted Delivery on the Female Pelvic Floor with Transperineal Ultrasound

作　　者：玄英华[1] 岳嵩[1] 杨丽曼[1] 安园园[1] 姜玉新[2] 吴青青[1] 

机构地区：[1]首都医科大学附属北京妇产医院超声科,北京市100026 [2]中国医学科学院、北京协和医学院、北京协和医院超声诊断科

出　　处：《中国超声医学杂志》2018年第1期62-65,共4页Chinese Journal of Ultrasound in Medicine

基　　金：北京市医院管理“登峰”计划专项经费资助(No.DFL20151302)

摘　　要：目的使用经会阴超声探讨产钳助产对女性肛提肌损伤和盆腔器官脱垂(POP)的短期及中长期影响。方法回顾性分析于我院超声科就诊的81例产钳助产术后妇女的经会阴超声容积数据。分为两组,短期组:包括45例,产钳助产术后平均(3.01±1.74)个月;中长期组:包括36例,产钳助产术后平均(47.93±2.68)个月。短期组和中长期组平均产时年龄为(32.98±3.60)岁和(30.70±3.14)岁;所分娩的新生儿出生体质量分别为(3 362.33±328.97)g和(3 381.21±429.50)g。结果短期组及中长期组分别有71.11%及41.67%病例发生肛提肌损伤,差异有统计学意义(P<0.01)。短期组肛提肌撕裂以及肛提肌裂孔面积增大的发生率较中长期组均显著增高(P<0.01、<0.05)。短期组和中长期组有意义的POP分别占45.45%及62.16%,差异无统计学意义(P>0.05);而前中后盆腔脱垂的组成两组有明显差异,短期组阴道前后壁膨出发生率较中长期组明显增高(均P<0.05),而中长期组子宫脱垂发生率显著升高(P<0.05)。结论产钳术后短期内肛提肌损伤和阴道前后壁膨出均可能有一定程度的随时间自行缓解。Objective To investigate the short term and mid-long term effects of forceps assisted delivery on the female levator ani injury and pelvic organ prolapse （POP） with transperineal ultrasound. Methods Retrospectively an- alyzed the volume data of the 81 women with forceps assisted delivery. All of the women received transperineal ultra- sound examination in Beijing Obstetrics and Gynecology Hospital from. The patients were divided into two groups： short term group： included 45 patients, （3.01±1.74） month after forceps assisted delivery; mid-long term group： 36 patients, （47.93±2.68） month after forceps assisted delivery. The mean ages of short term and mid-long term groups at delivery were （32.98±3.60） years and （30.70±3.14） years;the mean weights at birth of neonates were （3362.33±328.97） g and （3381.21±429.50） g respectively. Results 71.11% and 41.67% of patients in short term and mid long term groups demonstrated levator ani injuries, with statistic difference （P〈0.01）. The rate of avulsion of levator ani and enlargement of levator hiatus are were significantly increased in short term group （P〈0.01 and P〈0.05）. The incidences of uhrasonographically significant POP in short term and mid-long term groups were 45.45% and 62.16%, without significant difference（P〉0.05） ;the incidences of anterior and posterior vaginal wall prolapse were significant- ly increased in short term group （P〈O. 05）, while the incidence of uterine prolapse was significantly elevated in mid- long term group （P〈0.05）. Conclusions Our study indicated there may be spontaneous recovery of levator ani injury and anterior and posterior compartments POP to some extent after delivery.

关 键 词：三维超声 经会阴 肛提肌 损伤 POP 产钳 

分 类 号：R445.1[医药卫生—影像医学与核医学] R717[医药卫生—诊断学]