盆底超声在不同分娩方式产妇盆底功能障碍诊断及盆底康复治疗效果评估中的作用  

The role of pelvic floor ultrasound in the diagnosis of pelvic floor dysfunction and the evaluation of pelvic floor rehabilitation treatment effect in parturients with different delivery modes

作　　者：牛雅芳 段晓晓[2] NIU Yafang;DUAN Xiaoxiao(Ultrasound Department,People's Hospital of Zhongmu,Zhengzhou 451450;Ultrasound Department,Henan Provincial People's Hospital,Zhengzhou 450000,China)

机构地区：[1]中牟县人民医院超声科,河南郑州451450 [2]河南省人民医院超声科,河南郑州450000

出　　处：《临床医学研究与实践》2022年第7期133-136,共4页Clinical Research and Practice

摘　　要：目的探讨盆底超声在不同分娩方式产妇盆底功能障碍诊断及盆底康复治疗效果评估中的作用。方法选取2019年1月至2021年2月我院妇产科70例阴道自然分娩产妇与70例剖宫产分娩产妇作为研究对象,分别设为阴道分娩组、剖宫产组,产后均实施盆底超声检查。比较阴道分娩组与剖宫产组的盆底超声检查指标、盆底功能障碍发生情况。以盆底肌力诊断结果为参照,分析盆底超声对盆底功能障碍的诊断效能,并分析盆底超声与盆底肌力诊断结果之间的一致性。将阴道分娩组、剖宫产组中的盆底功能障碍产妇分别设为A组、B组,均实施盆底康复治疗,比较A组与B组治疗前、后的盆底超声检查指标、盆底肌力评分、阴道最大收缩压。结果阴道分娩组的膀胱颈移动度、静息及Valsalva动作时的肛提肌裂孔前后径、肛提肌裂孔左右径、肛提肌裂孔面积大于剖宫产组,差异具有统计学意义(P<0.05)。阴道分娩组的盆底功能障碍发生率为38.57%,高于剖宫产组的22.86%,差异具有统计学意义(P<0.05)。参照盆底肌力诊断结果,盆底超声对盆底功能障碍的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为97.67%、96.91%、97.14%、93.33%、98.95%;盆底超声与盆底肌力诊断结果之间存在高度一致性,Kappa值为0.834。治疗后,A组、B组的膀胱颈移动度、静息及Valsalva动作时的肛提肌裂孔前后径、肛提肌裂孔左右径、肛提肌裂孔面积均小于治疗前,盆底肌力评分、阴道最大收缩压均高于治疗前,差异具有统计学意义(P<0.05);治疗后,A组、B组的膀胱颈移动度、静息及Valsalva动作时的肛提肌裂孔前后径、肛提肌裂孔左右径、肛提肌裂孔面积、盆底肌力评分、阴道最大收缩压比较,差异无统计学意义(P>0.05)。结论盆底超声可对不同分娩方式产妇的盆底结构和功能进行检测,对盆底功能障碍具有较好的诊断Objective To explore the role of pelvic floor ultrasound in the diagnosis of pelvic floor dysfunction and the evaluation of pelvic floor rehabilitation treatment effect in parturients with different delivery modes.Methods From January 2019 to February 2021,70 parturients of vaginal natural delivery and 70 parturients of cesarean section delivery in the gynaecology and obstetrics department of our hospital were selected as the research objects.The parturients were divided into vaginal delivery group and cesarean section group,and the pelvic floor ultrasound examination was performed after delivery.The pelvic floor ultrasound examination indexes and occurrence of pelvic floor dysfunction were compared between the vaginal delivery group and the cesarean section group.Based on the diagnostic results of pelvic floor muscle strength,the diagnostic efficacy of pelvic floor ultrasound in pelvic floor dysfunction was analyzed,and the diagnostic results consistency between pelvic floor ultrasound and pelvic floor muscle strength was analyzed.The parturients with pelvic floor dysfunction in the vaginal delivery group and the cesarean section group were set up as group A and group B respectively,and the pelvic floor rehabilitation treatment was implemented.The pelvic floor ultrasound examination indexes,pelvic floor muscle strength score and vaginal maximum systolic pressure before and after treatment were compared between the group A and the group B.Results The bladder neck mobility,the anterior and posterior diameter of levator ani hiatus,the left and right diameter of levator ani hiatus and the area of levator ani hiatus during rest and Valsalva action in the vaginal delivery group were higher than those in the cesarean section group,and the differences were statistically significant(P<0.05).The incidence of pelvic floor dysfunction in the vaginal delivery group was 38.57%,which was higher than 22.86%in the cesarean section group,and the difference was statistically significant(P<0.05).Referring to the diagnostic results

关 键 词：盆底超声 分娩方式 盆底功能障碍 盆底康复治疗 阴道自然分娩 剖宫产分娩 

分 类 号：R711.2[医药卫生—妇产科学]