阴道分娩后超声检查盆腔组织器官解剖参数变化与患者盆底功能障碍性疾病相关性研究  

Changes in anatomical parameters of pelvic tissue and organs by ultrasound after vaginal delivery and their correlation with pelvic floor dysfunction

作　　者：高洁 苑翠翠 常洪坤 薛秀荣[1] 解莉 GAO Jie;YUAN Cuicui;CHANG Hongkun;XUE Xiurong;XIE Li(Department of Ultrasound,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061001,China)

机构地区：[1]河北省沧州中西医结合医院超声科,河北沧州061001 [2]威县人民医院妇科,河北威县054700

出　　处：《陕西医学杂志》2024年第2期189-193,198,共6页Shaanxi Medical Journal

基　　金：河北省卫生健康委员会医学科学研究课题(20220684)。

摘　　要：目的:探讨阴道分娩后超声检查盆腔组织器官解剖参数的变化及与患者盆底功能障碍性疾病的关系。方法:选阴道分娩后盆底功能障碍性疾病的患者82例作为观察组,其中盆腔器官脱垂(POP)34例,压力性尿失禁(SUI)26例,POP合并SUI 22例。同时选取阴道分娩后无盆底功能障碍的产妇80例作为对照组。比较各组盆腔超声参数差异,及其与盆底功能障碍性疾病的关系。结果:观察组膀胱颈至耻骨联合后下缘距离、宫颈至耻骨联合下缘距离明显低于对照组(均P<0.05),而膀胱下降度、宫颈下移、尿道旋转度明显高于对照组(均P<0.05)。观察组静息时、缩肛时、最大Valsalva动作时肛提肌裂孔前后径、肛提肌裂孔横径和肛提肌裂孔面积明显高于对照组(均P<0.05)。观察组POP合并SUI患者膀胱颈至耻骨联合后下缘的距离、宫颈至耻骨联合下缘的距离明显低于SUI、POP患者(均P<0.05),而膀胱下降度、宫颈下移明显高于SUI、POP患者(均P<0.05);观察组POP合并SUI患者观察组静息时、缩肛时、最大Valsalva动作时肛提肌裂孔前后径和肛提肌裂孔面积明显高于SUI、POP患者(均P<0.05);观察组POP合并SUI患者观察组静息时、最大Valsalva动作时肛提肌裂孔横径明显高于SUI、POP患者(均P<0.05)。膀胱下降度、宫颈下移、尿道旋转度与PFDI-20评分呈正相关(r=0.608、0.687、0.641,P<0.05)。膀胱下降度、宫颈下移诊断POP合并SUI的ROC曲线下面积分别为0.758(95%CI:0.643~0.872)和0.711(95%CI:0.585~0.838)(均P<0.05);尿道旋转度诊断POP合并SUI的ROC曲线下面积为0.564(95%CI:0.413~0.714)(P>0.05)。结论:阴道分娩后盆底功能障碍患者盆腔超声参数明显异常,其中膀胱下降度、宫颈下移、尿道旋转度与盆腔功能障碍症状严重程度有关。Objective:To explore the changes in anatomical parameters of pelvic tissue and organs using ultrasound after vaginal delivery and their relationship with pelvic floor dysfunction.Methods:82 patients with pelvic floor dysfunction after vaginal delivery were selected as the observation group,including 34 patients with pelvic organ prolapse(POP),26 patients with stress urinary incontinence(SUI),and 22 patients with POP combined with SUI.80 cases without pelvic floor dysfunction after vaginal delivery were selected as the control group.The differences in pelvic ultrasound parameters among different groups were analyzed and compared,and their relationship with pelvic floor floor dysfunction.Results:The distance from the bladder neck to the posterior lower edge of the pubic symphysis and the distance from the cervix to the lower edge of the pubic symphysis in the observation group were significantly lower than those in the control group(all P<0.05),while the degree of bladder descent,cervical descent,and urethral rotation were significantly higher than those in the control group(all P<0.05).The observation group showed significantly higher levels of anterior and posterior diameter,transverse diameter,and area of levator ani fissure during rest,anal contraction,and maximum Valsalva action compared to the control group(all P<0.05).The distance from the bladder neck to the posterior inferior edge of the pubic symphysis and the distance from the cervix to the inferior edge of the pubic symphysis in the observation group of POP combined with SUI were significantly lower than those in SUI and POP patients(all P<0.05),while the degree of bladder descent and cervical displacement were significantly higher than those in SUI and POP patients(all P<0.05).The observation group of POP combined with SUI patients showed significantly higher anterior and posterior diameters and area of levator ani muscle hiatus during rest,anal contraction,and maximum Valsalva action compared to SUI and POP patients(all P<0.05).The transverse diameter

关 键 词：盆底功能障碍 盆腔器官脱垂 压力性尿失禁 阴道分娩 超声检查 相关性 

分 类 号：R711.2[医药卫生—妇产科学]