子宫位置与盆腔器官脱垂的关系  

The Relationship Between Uterine Position and Pelvic Organ Prolapse

作　　者：张国慧 岳嵩[1] 玄英华[1] 安园园[1] Zhang Guohui;Yue Song;Xuan Yinghua;An Yuanyuan(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院北京妇幼保健院超声科,北京市100026

出　　处：《中国超声医学杂志》2024年第3期320-323,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨子宫位置与子宫脱垂的相关性。方法 回顾性分析经阴道分娩,并在产后1年内行经会阴三维盆底超声检查的998例患者的超声图像,根据子宫位置分为子宫前位组和子宫中后位组,比较两组中子宫脱垂的发生率。结果 所有病例中子宫前位440例(44%),子宫中后位558例(56%),两组年龄、体质量指数(BMI)、孕次、产次、产后天数均无统计学意义(P>0.05)。经会阴三维盆底超声检查结果显示两组间前盆腔膨出101例(23%vs.24%)、后盆腔膨出46例(10%vs.7%)、肛提肌撕裂19例(4%vs.4%)、肛提肌裂孔面积增大198例(45%vs.46%),均未见统计学意义(P>0.05)。子宫中后位组子宫脱垂发生率[28%(154/558)]明显大于子宫前位组[19%(82/440)],差异具有统计学意义(P=0.001),肛门括约肌损伤12例均发生在子宫前位组,差异具有统计学意义(P<0.001)。结论 子宫中后位组发生子宫脱垂的风险增高,子宫位置是产后子宫脱垂发生的危险因素,需要引起更多的关注。Objective To investigate the correlation between uterine position and uterine prolapse.Methods The ultrasound images of 998 patients who underwent vaginal delivery were retrospectively analyzed.Within one year after delivery,these patients also underwent three-dimensional perineal pelvic floor ultrasound.Based on the position of the uterus,they were divided into two groups:anterior uterine group and posterior uterine group.The incidence of uterine prolapse in these two groups was compared.Results Among all cases,there were 440(44%) in the anterior group and 558(56%) in the posterior group.There were no significant differences in age,body mass index(BMI),pregnancy times,delivery times,and postpartum days between the two groups(P>0.05).Perineal three-dimensional pelvic floor ultrasonography revealed that there were 101 cases of anterior pelvic cavity protrusion(23% vs.24%) and 46 cases of posterior pelvic cavity protrusion(10% vs.28%) in both groups respectively,19 cases(4% vs.4%) of levator ani muscle tear,and 198 cases(45% vs.46%) of increased levator ani muscle hiatus area between the two groups,but there was no statistically significant difference(P>0.05).The incidence of uterine prolapse in the posterior group of the uterus was 28%(154/558),which was significantly higher than that in the anterior group of the uterus 19%(82/440),and the difference was statistically significant(P=0.001).All 12 cases of anal sphincter injury occurred in the anterior group of the uterus,and the difference was statistically significant(P<0.001).Conclusions Uterine prolapse in the posterior group is associated with an increased risk for postpartum uterine prolapse;therefore,the position of the uterus should be given more attention as it serves as a risk factor for this condition.

关 键 词：子宫位置 脱垂 子宫 经会阴三维盆底超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.2[医药卫生—诊断学]