三维超声评估选择性会阴侧切术对初产妇盆底结构的近期影响  

Evaluation of the Short-term Effect of Selective Lateral Episiotomy on Pelvic Floor Structure of Primipara by Three-dimensional Ultrasound

作　　者：吕晨阳 向红[1] 李蕴琦 周慧丽[1] 付丽君 Lü Chenyang;Xiang Hong;Li Yunqi;Zhou Huili;Fu Lijun(Department of Ultrasound in Obstetrics and Gynecology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院妇产超声诊断科,乌鲁木齐市830054

出　　处：《中国超声医学杂志》2021年第12期1397-1401,共5页Chinese Journal of Ultrasound in Medicine

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项项目(No.WJWY-201930)。

摘　　要：目的研究三维超声评估选择性会阴侧切术对初产妇盆底结构的近期影响。方法对108例选择性会阴侧切术的初产妇以及与其行1:1配对的自然分娩但未行侧切术的初产妇在产后6〜8周行经会阴二维联合三维超声,观察并测量下列指标:最大Valsalva状态下膀胱后壁、宫颈至耻骨联合后下缘的距离,直肠壶腹相对肛门内括约肌膨出高度,膀胱后角,膀胱颈移动度,观察有无尿道内口漏斗形成,静息及最大Valsalva状态下肛提肌裂孔各参数,比较两组间的差异。结果两组间比较,膀胱颈移动度、膀胱后角、尿道漏斗内口的形成率以及盆腔内脏器的膨出率无统计学差异(P>0.05).两种状态下非会阴侧切组肛提肌裂孔的各参数均大于选择性会阴侧切组,差异有统计学差异(P<0.05)。结论选择性会阴侧切术对肛提肌近期内有一定的保护作用,在有指征的情况下行侧切术有价值。Objective To study the short-term effect of selective episiotomy on pelvic floor structure of primipara by three-dimensional ultrasound. Methods Two-dimensional ultrasound combined with three-dimensional ultrasound was performed 6-8 weeks after delivery in 108 cases of primipara who underwent selective lateral perineotomy and those who underwent 1∶1 natural delivery without lateral episiotomy. The following indexes were observed and measured: the distance from the posterior wall of bladder and cervix to the posterior inferior edge of pubic symphysis, the height of rectal ampulla relative to the internal sphincter of anus, the posterior angle of bladder, the mobility of bladder neck, the formation of internal urethral funnel, and the parameters of levator ani hiatus under resting and maximum Valsalva, and the differences between the two groups were compared. Results There was no significant difference in the degree of bladder neck movement, the posterior horn of bladder, the formation rate of urethral funnel and the dilation rate of pelvic organs between the two groups(P>0.05). Under the two conditions, the parameters of the levator ani hiatus in the non-perineal lateral resection group were greater than those in the selective perineal lateral resection group, and the differences were statistically different(P<0.05). Conclusions Selective lateral perineal resection has a certain protective effect on the levator ani muscle in the near future, and it is valuable to perform lateral resection when there are indications.

关 键 词：三维超声 选择性会阴侧切术 初产妇 盆底结构 

分 类 号：R445.1[医药卫生—影像医学与核医学] R713.2[医药卫生—诊断学]