盆底超声检查评估不同分娩方式对产后妇女耻骨直肠肌收缩功能的影响  

Assessment of the influencesof different delivery methods of contractibility of the puborectalis in postpartum women by pelvic ultrasound

作　　者：陈华[1] 王慧芳[1] 王瑾[1] 陈梦华[1] 郭娟[1] 邓晓双 Chen Hua;Wang Huifang;Wang Jin;Chen Menghua;Guo Juan;Deng Xiaoshuang(Department of Ultrasonography,the Second People′s Hospital of Shenzhen,the First Affiliated Hospital of Shenzhen University,Shenzhen 518035,China)

机构地区：[1]深圳市第二人民医院深圳大学第一附属医院超声科,518035

出　　处：《中华医学超声杂志（电子版）》2017年第6期452-457,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：深圳市卫生计生系统科研项目(201607022;201601027)

摘　　要：目的采用盆底超声检查评估不同分娩方式以及产后不同时间段盆底耻骨直肠肌(PR)收缩功能的恢复情况,探讨分娩方式对PR收缩功能的影响。方法选取2016年9~12月于深圳大学第一附属医院超声科检查且能有效完成盆底收缩动作的初产妇168名。100名产妇经阴道分娩,其中32名为产后42~60 d,45名为产后61~90 d,23名为产后>90 d;68名产妇为剖宫产,24名为产后42~60 d,23名为产后61~90 d,21名为产后>90 d。所有受检者均接受静息和收缩状态时经会阴二维超声检查:测量前、中及后份PR厚度并计算PR增厚率。采用独立样本t检验比较经阴道分娩组与剖宫产组产后42~60 d、产后61~90 d、产后>90 d产妇双侧PR增厚率差异。结果经阴道分娩组产后42~60 d产妇右侧PR前部、中部、后部增厚率分别为(35.57±19.80)%、(31.46±20.96)%、(24.18±21.51)%,左侧PR前部、中部、后部增厚率分别为(25.23±14.36)%、(21.25±13.79)%、(20.60±11.58)%;剖宫产组产后42~60 d产妇右侧PR前部、中部、后部增厚率分别为(30.27±19.22)%、(29.50±17.21)%、(28.25±14.92)%,左侧PR前部、中部、后部增厚率分别为(33.02±20.65)%、(30.56±20.11)%、(28.64±14.84)%。经阴道分娩组产后61~90 d产妇右侧PR前部、中部、后部增厚率分别为(29.62±16.93)%、(24.94±14.56)%、(19.26±11.12)%,左侧PR前部、中部、后部增厚率分别为(20.17±15.70)%、(19.95±13.07)%、(22.19±14.50)%,剖宫产组产后61~90 d产妇右侧PR前部、中部、后部增厚率分别为(30.82±15.65)%、(17.70±10.34)%、(19.30±7.02)%,左侧PR前部、中部、后部增厚率分别为(18.33±11.61)%、(16.46±10.51)%、(16.62±11.69)%。经阴道分娩组产后>90 d产妇右侧PR前部、中部、后部增厚率分别为(33.56±19.79)%、(25.18±11.80)%、(17.44±11.41)%,左侧PR前部、中部、后部增厚率分别为(28.06±10.93)%、(22.25±11.82)%、(22.15±12.69)%,剖宫产组产后>90 d产妇右侧PR前部、中部、后部增厚率分别�Objective To assess the recovery of contraction function of puborectalis（PR） in women at different periods after delivery with different delivery modes, and to discuss the effect of delivery mode on PR contraction. Methods Between September 2016 and December 2016, 168 primiparas who underwent ultrasound examination at the First Affiliated Hospital of Shenzhen University were enrolled. All participants were able to accomplish Valsalva maneuver. Participants were divided into two groups according to delivery modes： the vaginal delivery group and the cesarean section group. This two groups were further divided into three groups according to their periods after delivery： 42-60 days after delivery（group 1）, 61-90 days after delivery（group 2） and more than 90 days after delivery（group 3）. Two dimensional translabial ultrasound examination were performed in all participants both at rest and in maximal contraction status. Thickness of anterior, middle and posterior parts of PR were measured and thickening rate was calculated. Data were evaluated by t-test and comparisons were made between the vaginal delivery groups and cesarean section groups, respectively. Results In the vaginal delivery group 1, the thickening rate of the anterior, middle and posterior parts of right-side PR were（35.57±19.80）%,（31.46±20.96）% and（24.18±21.51）%, while the thickening rate of left-side PR were（25.23±14.36）%,（21.25±13.79）% and（20.60±11.58）%, respectively. In the cesarean section group 1, the thickening rate of the anterior, middle and posterior parts of right-side PR were（30.27±19.22）%,（29.50±17.21）% and（28.25±14.92）%, while the thickening rate of left-side PR were（33.02±20.65）%,（30.56±20.11）% and（28.64±14.84）%, respectively. In the vaginal delivery group 2, the thickening rate of the anterior, middle and posterior parts of right-side PR were（29.62±16.93）%,（24.94±14.56）% and（19.26±11.12）%, while the thickening rate of left-side PR were（20.17±1

关 键 词：超声检查 耻骨直肠肌 剖宫产术 自然分娩 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714[医药卫生—诊断学]