盆底三维超声评估不同分娩方式初产妇产后盆底解剖与功能变化的价值  

The value of pelvic floor three-dimensional ultrasonography in evaluating postpartum pelvic floor anatomy and function changes in primiparous women with different modes of delivery

作　　者：耿保阳 GENG Bao-yang(Liaocheng Maternal and Child Health Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市妇幼保健院,252000

出　　处：《中国实用医药》2022年第22期99-102,共4页China Practical Medicine

摘　　要：目的分析盆底三维超声应用于不同分娩方式初产妇产后盆底解剖与功能变化评估中的价值。方法130例初产妇,依据分娩方式不同将其分为对照组及观察组,每组65例。对照组为经阴道分娩初产妇,观察组为选择性剖宫产初产妇。两组初产妇均于产后6~8周接受盆底三维超声检查。比较两组初产妇的盆腔器官脱垂情况,膀胱颈下移距离与尿道旋转角度,不同状态下(静息状态下、缩肛动作时、Valsava动作时)肛提肌裂孔面积。结果观察组初产妇的前、中、后盆腔器官脱垂发生率分别为33.85%、15.38%、1.54%,均低于对照组的73.85%、32.31%、10.77%,差异具有统计学意义(P<0.05)。观察组初产妇的膀胱颈下移距离(19.85±1.04)mm、尿道旋转角度(38.51±3.37)°均小于对照组的(31.93±1.67)mm、(50.33±4.96)°,差异具有统计学意义(P<0.05)。观察组初产妇静息状态下、缩肛动作时、Valsava动作时的肛提肌裂孔面积分别为(13.09±1.54)、(8.95±0.86)、(17.23±2.06)cm^(2),均小于对照组的(14.13±1.79)、(9.79±1.05)、(20.94±3.17)cm^(2),差异具有统计学意义(P<0.05)。结论盆底三维超声检查应用于初产妇产后盆底功能障碍性疾病临床诊断中具有重要价值,且经阴道分娩初产妇的盆底功能和结构均较选择性剖宫产初产妇差。Objective To analyze the value of pelvic floor three-dimensional ultrasonography in evaluating postpartum pelvic floor anatomy and function changes in primipara with different modes of delivery.Methods A total of 130 primiparous women were divided into control group and observation group according to different modes of delivery,with 65 cases in each group.The control group received vaginal delivery,and the observation group received elective cesarean section.Both groups received three-dimensional ultrasonography of the pelvic floor at 6-8 weeks postpartum.Comparison was made on pelvic organ prolapse,bladder neck downward distance and urethral rotation angle,and levator hiatus area in different states(at rest,during anal retraction,and during Valsava maneuver).Results The incidence of anterior,middle,and posterior pelvic organ prolapse in the observation group were 33.85%,15.38%,and 1.54%,which were lower than 73.85%,32.31%,and 10.77%in the control group,and the differences were all statistically significant(P<0.05).The bladder neck downward distance(19.85±1.04)mm and the urethral rotation angle(38.51±3.37)°in the observation group were lower than(31.93±1.67)mm and(50.33±4.96)°in the control group,and the differences were all statistically significant(P<0.05).The levator hiatus area in the observation group at rest,during anal retraction,and during Valsava maneuver were(13.09±1.54),(8.95±0.86),and(17.23±2.06)cm^(2),which were smaller than(14.13±1.79),(9.79±1.05),and(20.94±3.17)cm^(2) in the control group,and the differences were all statistically significant(P<0.05).Conclusion Three-dimensional ultrasonography of the pelvic floor is of great value in the clinical diagnosis of postpartum pelvic floor dysfunction in primiparous women,and the pelvic floor function and structure of primiparous women with vaginal delivery are worse than those in primiparous women with selective cesarean section.

关 键 词：盆底三维超声 经阴道分娩 选择性剖宫产 初产妇 产后 盆底解剖 功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.5[医药卫生—诊断学]