经会阴三维超声联合实时剪切波弹性成像评价产后女性盆底功能的研究  

Evaluation of postpartum female pelvic floor function by transperineal three-dimensional ultrasound combined with real-time shear wave elastography

作　　者：蒋云秀 潘永寿[1] 潘焕贵 贺泉[2] 皮永前[1] 阮坚[1] 熊思[1] 秦蕾[1] JIANG Yun-xiu;PAN Yong-shou;PAN Huan-gui;HE Quan;PI Yong-qian;RUAN Jian;XIONG Si;QIN Lei(Department of Ultrasound,Liuzhou Municipal Liutie Central Hospital,Liuzhou 545007,Guangxi,China;Department of Obstetrics,Liuzhou Municipal Liutie Central Hospital,Liuzhou 545007,Guangxi,China)

机构地区：[1]广西壮族自治区柳州市柳铁中心医院超声科,广西柳州545007 [2]广西壮族自治区柳州市柳铁中心医院产科,广西柳州545007

出　　处：《生物医学工程与临床》2020年第1期45-49,共5页Biomedical Engineering and Clinical Medicine

基　　金：广西壮族自治区卫生和计划生育委员会科研自筹经费课题(Z20180172)。

摘　　要：目的探讨经会阴三维超声联合实时剪切波弹性成像(SWE)评价初产后女性盆底功能的价值。方法选择50例产后6~8周首次经阴道分娩产妇作为产后组,年龄22~33岁,平均年龄28.02岁。同时选择41例健康未育女性作为对照组,年龄20~34岁,平均年龄26.73岁。应用经会阴三维超声和SWE分别测量静息期和缩肛期肛提肌裂孔的前后径、左右径、面积、周长、肛提肌厚度,以及耻骨直肠肌的弹性模量值(即杨氏模量值),并进行两组间比较。结果产后组静息期和缩肛期肛提肌裂孔前后径、左右径、面积、周长均较对照组大,而肛提肌厚度和耻骨直肠肌的杨氏模量值均较对照组减小,差异有统计学意义(P<0.05)。产后组静息期和缩肛期肛提肌裂孔面积与耻骨直肠肌弹性均无显著相关性[静息期(左侧:r=-0.0589,P=0.684;右侧:r=-0.200,P=0.164);缩肛期(左侧:r=-0.275,P=0.053;右侧:r=-0.208,P=0.148)]。结论经会阴三维超声联合实时SWE可以更好地客观、准确评价产后女性盆底功能。Objective To evaluate postpartum female pelvic floor function by transperineal three-dimensional ultrasonography combined with real-time shear wave elastography(SWE).Methods A total of 50 first vaginal delivery 6 to 8 weeks maternal were enrolled as postpartum group,which aged 22-33 years old with mean age of 28.02 years old.Forty-one healthy pregnant females were selected as control group,which aged 20-34 years old with mean age of 26.73 years old.The transperineal three-dimensional ultrasound combined with SWE were used to measure anterior and posterior diameter,left and right diameter,area,length,levator ani muscle thickness at resting stage and shrinkage stage,and elastic Young’s modulus of puborectalis muscle,then compared between 2 groups.Results The anterior and posterior diameter,left and right diameter,area and length of postpartum group at resting stage and shrinkagel stage were larger than those of control group,but levator ani muscle thickness and Young’s modulus of puborectalis muscle were decreased,and difference were statistically significant(P<0.05).There was no significant correlation between hiatus area of levator ani and elasticity of puborectalis muscle in postpartum group[resting stage(left:r=-0.0589,P=0.684;right:r=-0.200,P=0.164);shrinkage stage(left:r=-0.275,P=0.053;right:r=-0.208,P=0.148)].Conclusion It is demonstrated that transperineal three-dimensional ultrasound combined with SWE could objectively and accurately evaluate postpartum female pelvic floor function.

关 键 词：经会阴三维超声 实时剪切波弹性成像 女性盆底功能 肛提肌裂孔 耻骨直肠肌 

分 类 号：R711[医药卫生—妇产科学] R445.1[医药卫生—临床医学]