经会阴三维超声评估育龄女性分娩方式对盆底功能的影响  

Adopting transperineal three-dimensional ultrasound evaluate the effect of delivery methods on pelvic floor function in women of childbearing age

作　　者：徐秋会 王晓慧[1] 董正秋 王薇[1] 曹霞[1] Xu Qiu hui(The first affiliaed hospital of JiamusiUniversity,Jianusi,Heilongjiang,154002,China)

机构地区：[1]佳木斯大学附属第一医院,黑龙江佳木斯154002

出　　处：《齐齐哈尔医学院学报》2021年第14期1228-1231,共4页Journal of Qiqihar Medical University

基　　金：黑龙江省教育厅项目(2019-kyywf-1352)。

摘　　要：目的采用经会阴三维超声评估分娩方式对盆底功能的影响。方法选择2018年5月—2019年3月在本院产科分娩后的107例产妇为研究对象,其中经阴道分娩71例作为阴道分娩组,剖宫产36例作为剖宫产组,两组均于产后6-8周来本院行经会阴三维超声检查。观察经阴道分娩组和剖宫产组产妇在静息状态下及最大Valsalva动作时膀胱颈至参考线下缘的垂直距离(BSD)、膀胱颈的移动度(BND)、膀胱尿道后角(RVA)、尿道旋转角度(URA)。结果孕龄、孕前身体质量指数(BMI)、新生儿体重均无显著差异(P>0.05);阴道分娩组、剖宫产组在静息状态和Valsalva状态下的BSD、膀胱颈移动度、尿道旋转角度的差异呈现统计学意义(P<0.05)。结论剖宫产比经阴道分娩在产后早期对盆底支持组织功能的影响要小。孕龄、孕前身体质量指数(BMI)、新生儿体重对盆底支持组织结构无明显影响。实时三维超声不但可以动态观察盆底组织的运动和变化,还可以对盆底结构的形态学及功能学进行评价,在探查盆腔脏器位置、形态与女性盆底功能障碍性疾病相关性中有一定应用价值。Objective To adopt transperineal three-dimensional ultrasound to evaluate the effect of delivery methods on pelvic floor function.Methods From May 2018 to March 2019, a total of 107 parturients, including 71 cases of vaginal delivery and 36 cases adopted cesarean section, were enrolled in the study. They were examined by three-dimensional ultrasound in perineum from 6 to 8 weeks after delivery.Observe the bladder neck-symphyseal distance(BSD) from the bladder neck to the lower edge of the reference line, the bladder neck descent(BND), retrovesical angel(RVA) and urethral rotation angle(URA), during the resting state and the maximum Valsalva motion of the women in the vaginal delivery group and the cesarean section.Results There was no significant difference in gestational age, pre-pregnancy body mass index(BMI), and newborn weight(P>0.05). The differences in BSD, bladder neck mobility, and urethral rotation angle under the resting state and Valsalva state between the vaginal delivery group and the cesarean section group were statistically significant(P<0.05).Conclusions Cesarean section has less effect on the function of pelvic floor supporting tissues in the early postpartum period than vaginal delivery. Gestational age, pre-pregnancy body mass index, and newborn weight have no significant effect on the structure of pelvic floor support tissues. Real-time three-dimensional ultrasound could not only dynamically observe the movement and change of pelvic floor, but also evaluate the morphology and function of pelvic floor structure, it is valuable in exploring the relationship between the position and shape of pelvic organs and pelvic floor dysfunction diseases in women.

关 键 词：三维超声 阴道分娩 剖宫产 盆底功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]