高频超声评价产后女性腹直肌分离类型的初步研究  

Preliminary study of high frequency ultrasound on evaluating the types of diastasis recti abdominis in postpartum women

作　　者：张明珠 牛敏昌 刘菲菲[3] 董景云[1] 唐丽玮[1] 高岩冰[1] ZHANG Ming-zhu;NIU Min-chang;LIU Fei-fei;DONG Jing-yun;TANG Li-wei;GAO Yan-bing(Department of Ultrasound,Binzhou Medical University Hospital,Binzhou Shandong 256600,China;Department of Ultrasound,Hekou District Hospital of Traditional Chinese Medicine,Dongying Shandong 257200,China;Department of Ultrasound,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]滨州医学院附属医院超声医学科,山东滨州256600 [2]东营市河口区中医院超声科,山东东营257200 [3]北京大学人民医院超声医学科,北京100044

出　　处：《中国临床医学影像杂志》2022年第3期201-205,共5页Journal of China Clinic Medical Imaging

基　　金：山东省医药卫生科技发展计划项目(2018WS543)。

摘　　要：目的:应用高频超声对产后女性腹直肌分离(DRA)的类型进行评价。方法:选取2020年9月—2021年4月我院行超声检查且产后时间为8~12周的产妇157例,应用高频超声测量脐上3 cm、脐上2 cm、脐部、脐下2 cm及脐下3 cm五个位置的腹直肌间距(IRD)。根据2019年疝学会发布的指南,任一位置IRD≥2 cm诊断为DRA;IRD<2 cm诊断为无DRA,并对DRA类型进行细分。同时,分析常见DRA类型的腹直肌最大间距及分娩方式的差异。结果:136例产妇经高频超声诊断为DRA,IRD宽度为2.00~7.71 cm,其中脐上分离型11例,脐水平分离型31例,脐及脐上分离型64例,脐及脐下分离型1例,全程分离型29例;常见DRA分离类型中全程分离型的IRD最大,其次为脐及脐上分离型,全程分离型选择性剖宫产比例显著高于其他类型(P<0.012)。结论:产后女性脐及脐上部同时发生DRA最常见,全程分离DRA程度最大,且选择性剖宫产女性比例大。高频超声可为产后女性DRA类型特征提供影像学依据,进而指导产后康复运动和手术方案的选择。Objective:To evaluate the types of diastasis recti abdominis(DRA)in postpartum women by high-frequency ultrasound.Methods:From September 2020 to April 2021,157 puerpera between 8 and 12 weeks after their delivery with the ultrasound examination were recruited in our study.They underwent high-frequency ultrasound to mearure the inter-rectus distance(IRD)at supraumbilical 3 cm,supraumbilical 2 cm,umbilicus,subumbilical 2 cm and supraumbilical 3 cm.According to the guidelines issued by the Hernia Society in 2019,any location with IRD≥2 cm diagnosed as DRA,IRD<2 cm diagnosed as non-DRA,and the DRA types were subdivided.At the same time,the differences of IRD and the modes of delivery in common DRA types were analyzed.Results:One hundred and thirty-six puerpera were diagnosed DRA by high-frequency ultrasound,and the width of IRD was 2.00 cm to 7.71 cm.Among them,11 were only separated from the supraumbilical,31 were separated from the umbilical,64 cases were separated from the umbilical and supraumbilical,1 was separated from the umbilical and subumbilical,and 29 were separated completely.Among the common DRA types,the IRD of total separation type was the largest,followed by umbilical and supraumbilical separation type.The proportion of women undergoing selective cesarean section in whole separation type was significantly higher than that in other types(P<0.012).Conclusions:The DRA which occurred simultaneously at umbilical and supraumbilical is the most common in postpartum women.The whole separa-tion type with high degree of separation has higher proportion of women in cesarean section.High-frequency ultrasound can provide imaging basis for subtyping DRA in postpartum women,and guide the postpartum rehabilitation exercise and operation plans.

关 键 词：腹直肌 超声检查 

分 类 号：R323.31[医药卫生—人体解剖和组织胚胎学] R337[医药卫生—基础医学]