超声评估初产妇产后6周腹直肌分离情况及影响因素  

Diastasis Recti Abdominis in Primipara Women at 6 Weeks After Childbirth Measured by Ultrasound and Risk Factors

作　　者：蔡留芸 邓芯茹 陆彦旭 罗小东[1] CAI Liuyun;DENG Xinru;LU Yanxu;LUO Xiaodong(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院妇产科超声,重庆400010

出　　处：《中国医学影像学杂志》2021年第11期1134-1138,共5页Chinese Journal of Medical Imaging

摘　　要：目的超声检测初产妇产后6周时多个位点的腹直肌间距离(IRD),并分析腹直肌分离(DRA)的危险因素。资料与方法回顾性选择1116例初产妇,超声测量静息状态及屈曲状态下5个位点(脐环上5 cm、脐环上3 cm、脐环处、脐环下3 cm、脐环下5 cm)的IRD,比较不同位点及不同状态下的IRD,分析影响产后6周DRA的因素。结果产后6周静息状态下5个位点的IRD分别为(18.96±8.27)cm、(22.58±8.03)cm、(31.61±9.82)cm、(12.93±8.03)cm、(2.56±5.38)cm,屈曲状态下5个位点的IRD分别为(15.85±7.17)cm、(18.81±7.43)cm、(22.03±8.96)cm、(8.59±6.32)cm、(1.57±4.20)cm。同一位点静息状态下IRD均大于屈曲状态,差异有统计学意义(t=17.137、4.512、8.632、27.652、71.829,P均<0.05)。静息状态和屈曲状态下脐环处IRD均显著大于其余4个位点,差异有统计学意义(F=1339.81、2000.64,P均<0.001)。Logistic回归分析显示,剖宫产(OR=2.07,95%CI 1.62~2.65)、新生儿体质量≥3500 g(OR=1.39,95%CI 1.08~1.83)、腹围≥100 cm(OR=2.08,95%CI 1.58~2.75)、宫高≥35 cm(OR=1.39,95%CI 1.08~1.81)及双胎妊娠(OR=5.73,95%CI 1.78~18.50)是产后6周发生DRA的危险因素(P均<0.001)。结论产后6周时产妇DRA发生率高,以轻度和中度为主。控制胎儿体质量,避免孕期腹部肌肉过度拉伸,同时减少非必要的剖宫产,可能会降低产后6周DRA发生率。Purpose To investigate the inter-rectus distance(IRD)at different sites in primipara women at 6 weeks after childbirth measured by ultrasound,and to analyze the prevalence and the risk factors of diastasis recti abdominis(DRA).Materials and Methods A total of 1116 primipara women at 6 weeks after childbirth were retrospectively collected.IRD was measured at 5 locations(5 cm above the umbilical ring,3 cm above the umbilical ring,the umbilical ring,3 cm below the umbilical ring,and 5 cm below the umbilical ring)both in the resting state and flexion state with ultrasound transducer,analyzing the different sites and states of IRD and the risk factors of DRA,respectively.Results IRD measured at 5 locations in resting state of primipara women at 6 weeks after childbirth was(18.96±8.27)cm,(22.58±8.03)cm,(31.61±9.82)cm,(12.93±8.03)cm,(2.56±5.38)cm,respectively.IRD measured in flexion state was(15.85±7.17)cm,(18.81±7.43)cm,(22.03±8.96)cm,(8.59±6.32)cm,(1.57±4.20)cm,respectively.There was significant difference in the same site of IRD between resting state and flexion state,and IRD of resting state was significantly larger than that of flexion state(t=17.137,4.512,8.632,27.652 and 71.829,P<0.05).The IRD at the umbilical ring was significantly higher than that at the other four sites(F=1339.81,2000.64;P<0.001).According to the results of Logistic regression analysis,cesarean section(OR=2.07,95%CI 1.62-2.65,P<0.05),newborn weight≥3500 g(OR=1.39,95%CI 1.08-1.83,P<0.05),abdominal circumference≥100 cm(OR=2.08,95%CI 1.58-2.75,P<0.05),uterine height≥35 cm(OR=1.39,95%CI 1.08-1.81,P<0.05),twin pregnancy(OR=5.73,95%CI 1.78-18.50,P<0.05)were the independent risk factors for DRA at 6 weeks postpartum.Conclusion The high incidence of DRA could be occurred,and mild and moderate DRA is mainly in primipara women at 6 weeks after childbirth.Controlling fetal weight,avoiding excessive abdominal muscle stretching during pregnancy,and reducing unnecessary cesarean sections may reduce the incidence of high rectus separation at

关 键 词：腹直肌分离 腹直肌间距离 初产妇 产后6周 危险因素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R323.31[医药卫生—诊断学]