肛提肌尿道间隙评价产后女性肛提肌损伤的初步应用

A preliminary application of levator-urethra gap in evaluating levtor avulsion in postpartum women

目的应用盆底三维超声研究阴道分娩后女性盆底肛提肌尿道间隙（1evator—urethragap，LUG）的变化。方法选取我院80例阴道分娩后女性及30例未育女性进行盆底三维超声检查，采集盆底肌收缩期图像，在断层超声图像上观察耻骨直肠肌的形态，并测量左右侧LUG。结果未育组双侧耻骨直肠肌均完整，产后组中69例双侧耻骨直肠肌完整，11例耻骨直肠肌撕脱。产后组的LUG值明显大于未育组，差异有统计学意义（P〈0．05）。产后组撕脱侧LUG值明显大于未撕脱侧LUG值，差异有统计学意义（P〈0．05）。未育组、产后未撕脱组左右两侧LUG值差异无统计学意义（P〉0．05）。结论LUG是一种较好的评估产后女性肛提肌损伤的影像学参数。

Objective To study the change of levator-urethra gap（LUG） in postpartum female using pelvic floor three-dimensional ultrasonography. Methods Totally 80 postpartum women and 30 nulliparas were examined by three-dimensional pelvic floor ultrasonography. The images were obtained at maximal pelvic floor muscle contraction,and then the morphology of puborectalis muscle on tomographic ultrasound imaging were observed and the right LUG and left LUG were measured. Results The puborectalis was intact in all nulliparas and 69 postpartum women. The puborectalis avulsion was find in 11 postpartum women. The LUG of postpartum group was greater than that of nullipara group （ P〈0.05）. In postpartum group,the LUG of puborectalis avulsion was greater than that of intact puborectalis（ P 〈0.05）. There was no difference between the right LUG and left LUG in nullipara group and in the postpartum women with intact puborectalis （ P 〉0.05）. Conclusions LUG is a good imaging parameter to evaluate the levator avulsion in postpartum women.