多模态超声评估不同分娩方式对妊娠期肥胖患者肛提肌形态的影响  

Multimodal Ultrasound Evaluation of the Effect of Different Delivery Methods on the Morphological of Levator Ani Muscle in Obese Pregnant Patients

作　　者：孙新党 史景璐 李国芳 温寒寒 曹青峰 吕林娜 SUN Xindang;SHI Jinglu;LI Guofang;WEN Hanhan;CAO Qingfeng;L Linna(Department of Ultrasound,the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People’s Hospital),Zhengzhou 450000,China;Department of Obstetrics,the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People’s Hospital),Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)超声科,河南郑州450000 [2]河南中医药大学第五临床医学院(郑州人民医院)产科,河南郑州450000

出　　处：《河南医学研究》2025年第6期1028-1031,共4页Henan Medical Research

摘　　要：目的分析经多模态超声评估不同分娩方式对妊娠期肥胖患者肛提肌形态变化影响的价值。方法回顾性采集2023年6月至2024年6月于郑州人民医院分娩的123例妊娠期肥胖初产妇的临床资料,根据分娩方式分为顺产组(40例)、剖宫产组(51例),另于医院体检中心采集接受体检的50例健康已婚未育女性资料,将其作为对照组,3组均接受多模态超声检查。仔细查阅受检者资料,记录并对比3组在不同状态下肛提肌裂孔前后径、左右径、面积,以及杨氏模量值,记录并比较顺产组与剖宫产组的肛提肌损伤情况。结果顺产组、剖宫产组不同状态下的肛提肌裂孔前后径、左右径、面积均大于对照组,且顺产组大于剖宫产组(P<0.05);顺产组、剖宫产组的左侧、右侧静息、最大收缩状态下杨氏模量值及其差值均低于对照组,且顺产组低于剖宫产组(P<0.05)。剖宫产组肛提肌损伤发生率低于顺产组(P<0.05)。结论不同分娩方式对妊娠期肥胖患者肛提肌形态变化的影响有所差异,顺产的影响较剖宫产大,这种肛提肌形态的变化可应用多模态超声评估。Objective To analyze the value of multimodal ultrasound in evaluating the effects of different delivery methods on the morphological changes of the levator ani muscle in obese pregnant patients.Methods A retrospective analysis was conducted on 123 obese primiparous women who gave birth at Zhengzhou People’s Hospital from June 2023 to June 2024.They were divided into vaginal delivery group(40 cases)and cesarean section group(51 cases)according to the delivery method.In addition,data from 50 healthy married women who underwent physical examination at the hospital’s physical examination center were collected as the control group.All three groups underwent multimodal ultrasound examination.The data of the subjects were carefully reviewed,and the anteroposterior diameter,left and right diameter,area and Young’s modulus of the levator hiatus in the three groups under different conditions were recorded and compared.The injury of the levator ani muscle in the natural delivery group and the cesarean section group was recorded and compared.Results The anterior posterior diameter,left-right diameter,and area of the anal sphincter hiatus in the vaginal delivery group and cesarean section group were all larger than those in the control group under different conditions,and the vaginal delivery group was larger than the cesarean section group(P<0.05).The resting and maximum systolic Young’s modulus values and their differences of the left and right sides in the vaginal delivery group and cesarean section group were lower than those in the control group,and the vaginal delivery group was lower than the cesarean section group(P<0.05).The incidence of anal sphincter injury in the cesarean section group was lower than that in the vaginal delivery group(P<0.05).Conclusion Different delivery methods have varying effects on the morphological changes of the levator ani muscle in obese patients during pregnancy.The impact of vaginal delivery is greater than that of cesarean section,and this change in levator ani muscle morpholog

关 键 词：妊娠 肥胖 肛提肌形态 多模态超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]