超声评估新生儿体质量对产后女性肛提肌裂孔形态及功能的影响  

The effect of neonatal body mass on the hiatus shape and function of levator ani muscle of postpartum women as ultrasound assessment

作　　者：王大莲 刘洪[1] 李嘉舟 孙露[1] 徐向东[1] 郑东[1] WANG Da-lian;LIU Hong;LI Jia-zhou(Ultrasound Department,Dazhou Integrated Traditional Chinese Medicine and Western Medicine Hospital,Dazhou 635000,China;不详)

机构地区：[1]达州市中西医结合医院超声科,四川达州635000

出　　处：《中国医学装备》2023年第7期91-95,共5页China Medical Equipment

基　　金：四川省卫生健康委适宜技术推广项目(20SYJS045)“超声评估新生儿体质量对产后女性肛提肌裂孔形态及功能的影响”;达州市科技计划(20YYJC0005)“超声评价围产期妇女腹壁肌群动态变化的临床价值研究”。

摘　　要：目的:探讨超声评估新生儿体质量对产后女性肛提肌裂孔形态及功能的影响。方法:选取在医院分娩的134例西南地区产后初产妇,按照新生儿出生时的体质量将产妇分为正常组(93例)和巨大组(41例),采用超声评估产妇肛提肌裂孔的形态和损伤情况,比较两组产妇肛提肌裂孔各径线超声检测结果、不同状态肛提肌裂孔面积以及肛提肌肌力情况。结果:正常组产妇肛提肌裂孔的周长(LHC)、直径(LHD)、横径(LHW)、前后径(LHAP)以及尿道中点至肛提肌的距离(LUG)明显低于巨大组产妇,差异有统计学意义(t=-5.718,t=-5.919,t=-9.940,t=-12.621,t=-4.124;P<0.05)。正常组产妇的静息状态、缩肛状态以及Valsalva动作产后3d、42d和90d时的肛提肌裂孔面积明显低于巨大组产妇,差异均有统计学意义(t_(静息状态)=-8.058,t=-9.794,t=-11.478;t_(缩肛状态)=-9.644,t=-10.058,t=-10.794;t_(Valsalva动作)=-14.375,t=-13.462,t=-13.056;P<0.05)。重复测量显示,两组产妇的静息状态、缩肛状态及Valsalva动作产后3个时间点(3d、42 d及90d)的肛提肌裂孔面积比较,差异均有统计学意义(F=11.944,F=25.733,F=23.613;P<0.05)。两组肛提肌肌力0级、2级、3级、4级及5级比较差异均无统计学意义,正常组产妇肛提肌肌力1级发生率为21.51%(20/93),明显低于巨大组产妇[39.02%(16/41)],差异均有统计学意义(x^(2)=4.445,P<0.05)。结论:经会阴二维及三维超声、断层超声可有效评估西南地区新生儿体质量对初产妇肛提肌的影响,分娩巨大儿易导致产后女性肛提肌损伤以及功能改变。Objective:To explore the effect of neonatal body mass on the hiatus shape and function of levator ani muscle of postpartum women as ultrasound assessment.Methods:A total of 134 postpartum primipara who delivered in hospital were selected and they were divided into the normal group(93 cases)and the macrosomia group(41 cases)according to body mass of neonates at birth.The hiatus shape and injury of levator ani muscle of delivery women were assessed by ultrasound,and the results of ultrasonic examination of each diameter line of the hiatus of levator ani muscle of delivery women,the area of the hiatus of levator ani muscle in different states and the muscle strength of levator ani muscle were compared between the two groups.Results:The levator hiatus circumference(LHC),diameter of levator hiatus(LHD),width of levator hiatus(LHW),antero-posterior of levator hiatus(LHAP)and the levator-urethra gap(LUG)in the normal group were significantly lower than those in the macrosomia group(t=-5.718,t=-5.919,t=-9.940,t=-12.621,t=-4.124,P<0.05),respectively.The area of the hiatus of levator ani muscle of delivery women in resting state,contraction state and valsalva action at the postpartum 3rd d,42th d and 90th d in the normal group were significantly lower than those in the macrosomia group(t_(resting state)=-8.058,t=-9.794,t=-11.478,t_(contraction state)=-9.644,t=-10.058,t=-10.794,t_(valsalva action)=-14.375,t=-13.462,t=-13.056,P<0.05),respectively.The results of repeated measurement showed that there were significant differences in the areas of the hiatus of levator ani muscle at resting state,contraction state and Valsalva action at the postpartum 3rd d,42th d and 90th d between two groups(F=11.944,F=25.733,F=23.613,P<0.05),respectively.There were not significant at the grade 0,grade 2,grade 3,grade 4,and grade 5 of the strength of levator ani muscle between the two groups(P>0.05),respectively.The incidence of the grade 1 of levator ani muscle strength in the normal group was 21.51%,which was significantly lower than 39.02%i

关 键 词：超声 西南地区 新生儿 体质量 初产妇 肛提肌裂孔 

分 类 号：R445.1[医药卫生—影像医学与核医学]