四维盆底超声评估针灸治疗产后女性盆底功能障碍疗效的价值

Evaluation of the therapeutic efficacy of acupuncture and moxibustion on postpartum female pelvic floor dysfunction by four-dimensional pelvic floor ultrasound

目的探讨四维盆底超声对产后女性盆底障碍与针灸治疗产后女性盆底功能障碍的诊断价值。方法选择金华市妇幼保健院妇产科2019年1—5月收治的80例产后女性盆底功能障碍患者与同期产后无盆底功能障碍的80例妇女开展前瞻性研究,分别设置为观察组、对照组,对2组妇女进行四维盆底超声检查,比较观察组与对照组的肛提肌裂孔情况。将观察组患者分为2组,各40例,比较2组的四维盆底超声检测指标、盆底肌力评分、阴道最大收缩压。结果在静息状态、缩肛状态,观察组的肛提肌裂孔前后径、左右径、面积均大于对照组,其肛提肌厚度小于对照组(均P<0.05)。治疗后,观察2组的肛提肌裂孔前后径、左右径、面积均小于观察1组(均P<0.05),其肛提肌厚度大于观察1组(均P<0.05)。治疗后,观察2组的盆底肌力评分、阴道最大收缩压均高于观察1组(均P<0.05)。结论四维盆底超声可清晰、直观地显示盆底功能障碍女性患者盆底结构的形态学特点,还可客观评估针灸治疗盆底功能障碍的临床效果,可将四维盆底超声作为盆底功能障碍的辅助诊断手段和疗效评估方法。

Objective To explore the diagnostic value of four-dimensional pelvic floor ultrasound for postpartum female pelvic floor disorders and acupuncture treatment of postpartum female pelvic floor dysfunction.Methods Eighty prospective women with postpartum pelvic floor dysfunction and 80 women without pelvic floor dysfunction during the same period were selected to conduct a prospective study.They were set as observation group and control group,and two groups of women were subjected to four-dimensional pelvic floor ultrasound examination,Compare the levator anal fissure in the observation group with the control group.Patients in the observation group were divided into 2 groups of 40 cases each,and the four-dimensional pelvic floor ultrasound detection index,pelvic floor muscle strength score,and maximum vaginal systolic pressure in the two groups were compared.Results In the resting state and the anus contraction state,the anterior and posterior diameters,left and right diameters,and areas of the levator ani muscle in the observation group were larger than the control group,and the thickness of the levator ani muscle was smaller than the control group(all P<0.05).After treatment,the anterior levator rupture hole in the two groups was smaller than the observation group 1(all P<0.05),and the thickness of the levator ani muscle was larger than that in the observation group 1(both P<0.05).After treatment,the pelvic floor muscle strength score and the maximum vaginal systolic blood pressure in the observation group were higher than those in the observation group(both P<0.05).Conclusion Four-dimensional pelvic floor ultrasound can clearly and intuitively display the morphological characteristics of pelvic floor structure in female patients with pelvic floor dysfunction.It can also objectively evaluate the clinical effect of acupuncture in the treatment of pelvic floor dysfunction.Auxiliary diagnostic methods and efficacy evaluation methods for disorders.