经会阴超声观察不同分娩方式对盆底结构的影响

To observe the influence of different delivery methods on pelvic floor structures by perineum ultrasound

目的经会阴超声观察不同分娩方式女性产后盆底结构,为研究盆底功能障碍性疾病提供影像学依据。方法初产妇69例,分为经阴道分娩组39例和剖宫产组30例,产后6~8周,经会阴超声分别在静息状态、瓦氏动作时测量盆膈裂孔面积、周长、前后径、左右径及膀胱颈移动度(BND)。结果经阴道分娩组静息状态下,盆膈裂孔面积、周长、前后径及左右径均大于剖宫产组(均P<0.05);经阴道分娩组BND大于剖宫产组(P<0.05);同组瓦氏动作时各参数大于静息状态(P<0.01);两组瓦氏动作时各参数差异无统计学意义。结论经会阴超声观察产后盆底结构,为女性盆底功能障碍性疾病的早期防治提供辅助诊断依据。

Objective To investigate the conditions of pelvic floor structures in postpartum women with different delivery methods by perineum ultrasound and to provide imaging evidence for studing pelvic floor dysfunctional disease. Methods Sity-nine primiparas including 39 cases with vaginal delivery and 30 cases with cesarean delivery were included. Six^eight weeks after birth,perineum ultrasonography was performed in all of them and the pelvic diaphragm hiatal areas, perimeters,anteroposterior diameters,the left to right diameters and bladder neck descent were respectively measured under the conditions of resting state and valsalva maneuver. Results Under the conditions of resting state,the pelvic diaphragm hiatal areas,perimeters and anteroposterior diameters in the vaginal delivery group were greater than those in the cesarean delivery group （P〈0.01）,the left to right diameters were greater than those in the cesarean delivery group（P＆lt;0.05）,the bladder neck descents were greater than those in the cesarean delivery group,the differences were statistically significant（P＆lt;0.05）. In the same group, parameters were greater under the condition of valsalva maneuver compared to those under the condition of resting state,there were significant statistically differences（P＆lt;0 . 01）. Under the condition of valsalva maneuver ,no statistical differences were found between the two gourps（P〉0.05）. Conclusion Perineum ultrasound can be used to observe the change of postpartum pelvic floor structures,which can provide auxiliary evidence for the early prevention and treatment of female pelvic floor dysfunctional diseases.