产后42天早期盆底康复对盆底功能障碍预防的超声评估

Ultrasound Evaluation of Early Pelvic Floor Rehabilitation after 42 Days Postpartum Preventing Pelvic Floor Dysfunction

目的探讨超声在评估产后42 d盆底康复中的应用价值。方法选取124例初产妇作为研究对象,随机分为两组,观察组(61例)于产后42 d进行盆底康复治疗,对照组(63例)采取一般的健康教育措施。分别于产后42 d和产后3个月采用彩色多普勒超声诊断仪进行评估,比较两组产妇的超声相关参数及康复效果。结果产后3个月,观察组的膀胱颈下降值(BND)、静止期膀胱尿道后角(PUVA-R)、压力期膀胱尿道后角(PUVA-S)、尿道膀胱连接部移动度(UVJ-M)等指标均明显小于对照组(P<0.05),而观察组的膀胱颈至耻骨联合下缘的垂直间距(BSD-S)、I类肌纤维肌力、II类肌纤维肌力则明显大于对照组(P<0.01)。观察组产后3个月的BND、PUVA-R、PUVA-S及UVJ-M均比产后42 d明显减小(P<0.05),而盆底肌力(I、II类肌纤维肌力)均较产后42 d明显增大(P<0.01)。结论产妇产后42 d进行早期盆底康复治疗,可有效提高盆底功能,预防产后尿失禁及盆腔器官脱垂的发生,而彩色多普勒超声则可有效评估盆底功能。

Objective To explore the application value of ultrasound in evaluation of postpartum 42 days pelvic floor rehabilitation therapy. Methods 124 primipars at 42 d after delivery were chosen and randomly divided into two groups： observation group（61 cases） and control group（63 cases）. The observation group carried out pelvic floor rehabilitation therapy, whereas the control group was given conventional health education measures. Fourty-two days and 3 months after delivery, color Doppler ultrasound was performed to compare the ultrasonic parameters and rehabilitation efficacy between the two groups. Results 3 months after delivery, the indexes of BND, PUVA-R, PUVA-S and UVJ-M in the observation group were much lower than the control group（P〈0.05）, but BSD-S, type I and type II muscle fiber strength in the observation group were much higher than the control group（P〈0.01）. The indexes of BND, PUVA-R, PUVA-S and UVJ-M in the observation group at 3 months after delivery were much lower than postpartum 42 d（P〈0.05）. Yet the pelvic floor muscle strength（type I and type II） in the observation group at 3 months after delivery were much larger than postpartum 42 d（P〈0.01）. Conclusion Primiparas can carry out postpartum 42 d pelvic floor rehabilitation therapy, so as to improve pelvic floor function, prevent the incidences of urinary incontinence and pelvic prolapse. And meanwhile, color Doppler ultrasound can effectively evaluate the pelvic floor function.