探讨经会阴盆底四维超声在椎管内镇痛分娩及会阴侧切分娩后早期预测SUI发生的临床价值  

To explore the clinical value of transperineal pelvic floor four-dimensional ultrasound in early prediction of the occurrence of SUI after intraspinal analgesia delivery and perineal lateral incision delivery

作　　者：老兆航 徐晓红 吴杏仪 朱雅芸 林燕霞 胡凤仪 Lao Zhaohang;Xu Xiaohong;Wu Xingyi(The Shunde Women and Children's Hospital of Guangdong Medical University,Foshan,Guangdong 528300;The Affliatied Hospital of Guangdong Medical University,Zhanjiang,Guangdong 524000)

机构地区：[1]广东医科大学顺德妇女儿童医院,佛山市顺德区妇幼保健院,广东佛山528300 [2]广东医科大学,广东医科大学附属医院,广东湛江524000

出　　处：《基层医学论坛》2022年第10期8-10,F0003,共4页The Medical Forum

基　　金：佛山市科技创新项目自筹经费类科技计划项目(1920001000618)。

摘　　要：目的探讨经会阴盆底四维超声在椎管内镇痛分娩及会阴侧切分娩后早期预测压力性尿失禁(SUI)发生的临床价值。方法回顾性分析2020年1月—2021年5月于广东医科大学顺德妇女儿童医院复查的100例经阴道分娩初产妇临床资料,将采用椎管内镇痛分娩的55例产妇纳入椎管内镇痛分娩组,采用会阴侧切分娩的45例产妇纳入会阴侧切分娩组。产妇于产后6~8周到院复诊,均进行经会阴盆底四维超声检查。比较2组静息期(R)、张力期最大Valsalva动作(V)状态下的膀胱尿道后角(PUA)、张力期最大Valsalva动作(V)状态下的膀胱颈移动度(BND)、尿道旋转角(URA)、肛提肌裂孔面积(LHA)及尿道内口漏斗形成率。结果椎管内镇痛分娩组R-PUA、V-PUA、V-URA、V-LHA、V-BND均低于会阴侧切分娩组,椎管内镇痛分娩组尿道内口漏斗形成率(23.64%)低于会阴侧切分娩组(57.78%),差异有统计学意义(P<0.05)。结论椎管内镇痛分娩有利于降低SUI发生,采用经会阴盆底四维超声能够对椎管内镇痛分娩、会阴侧切分娩后SUI进行早期预测,进而指导临床诊治。Objective To explore the clinical value of transperineal pelvic floor four-dimensional ultrasound in the early prediction of stress urinary incontinence(SUI)after intraspinal analgesia and lateral perineal delivery.Methods A retrospective analysis of the clinical data of 100 primiparas undergoing vaginal delivery at the Shunde Women and Children's Hospital of Guangdong Medical University from January 2020 to May 2021 was retrospectively analyzed.55 primiparas who gave birth with intraspinal analgesia were included in intraspinal analgesia In the delivery group,45 parturients who were delivered by perineal lateral incision were included in the perineal lateral incision delivery group.The parturients came to the hospital for follow-up visits 6-8 weeks postpartum,all of them underwent transperineal pelvic floor four-dimensional ultrasound examination.The bladder urethral posterior angle(PUA),bladder neck mobility(BND),urethral rotation angle(URA),levator ani muscle hole area(LHA)and the formation rate of the funnel in the urethra.Results The R-PUA,V-PUA,URA,LHA and BND in the intraspinal analgesia delivery group were lower than those in the perineal lateral resection group,and the formation rate of the urethral ostium in the intraspinal analgesia delivery group(23.64%)was lower than that in the perineal lateral resection group.Group(57.78%),the difference was statistically significant(P<0.05).Conclusion Intraspinal analgesia delivery is beneficial to reduce the occurrence of SUI.The use of transperineal pelvic floor four-dimensional ultrasound can early predict SUI after intraspinal analgesia delivery and perineal lateral incision delivery,and then guide clinical diagnosis and treatment.

关 键 词：椎管内镇痛分娩 会阴侧切分娩 压力性尿失禁 经会阴盆底四维超声 预测价值 

分 类 号：R641.4[医药卫生—外科学]