产后盆底功能障碍女性应用三维超声评估盆底功能康复治疗效果分析

Clinical Evaluation of Pelvic Floor Functional Rehabilitation Treatment On Women with Postpartum Pelvic Floor Dysfunction Using Three-Dimensional Ultrasound

目的:研究产后盆底功能障碍女性应用经会阴三维超声进行观察康复治疗并评估对盆底结构影响的临床分析。方法:选取2015年10月-2017年8月经本院确诊为女性盆底功能性障碍疾病的患者120例,根据序列号随机分为观察组与康复组,各60例。观察组给予产后保健操、常规教育护理,康复组给予康复治疗并结合观察组护理方法进行护理,两组均采用经会阴三维超声监测其治疗前后的情况,并监测静息到瓦氏动作患者膀胱颈位置的具体变化。结果:观察组治疗后盆膈裂孔面积、周长及静息时盆膈裂孔前后径均明显低于治疗前,差异均有统计学意义(P<0.05);康复组上述指标比较,差异均无统计学意义(P>0.05)。两组经临床治疗后面积、周长以及静息时盆膈裂孔前后径均低于治疗前(P<0.05)。观察组治疗后显示耻骨直肠肌宽度与治疗前比较,差异无统计学意义(P>0.05);康复组治疗后耻骨直肠肌明显优于治疗前(P<0.05);瓦氏动作时盆底膈裂孔前后径、面积、周长及膀胱颈移动度(BND)明显低于治疗前(P<0.05),观察组上述指标比较差异均无统计学意义(P>0.05),且康复组治疗后上述指标数据,显著低于观察组治疗后(P<0.05)。结论:产后女性盆底功能障碍性疾病经临床科学康复治疗后能有效改善盆底结构及功能,且应用经会阴三维超声可有效地评估康复治疗情况。

Objective:To investigate the clinical efficacy of transperineal ultrasound on the treatment of postpartum pelvic floor dysfunction and evaluate the effect on pelvic floor structure.Method:From October 2015 to August 2017,120 cases of female pelvic floor dysfunction diagnosed in our hospital,according to the random number table method,were divided into the observation group and the rehabilitation group,60 cases in each group.The observation group was given routine postpartum health care,education and nursing.The rehabilitation group was given rehabilitation treatment and combined with the nursing method of the control group,Both groups were monitored by transperineal three-dimensional ultrasound before and after treatment,and monitored the specific changes of bladder neck position in patients with resting to the Vale’s motion.Result:In the observation group,the area,circumference and the anterior and posterior diameter of the pelvic diaphragm hiatus were significantly lower than those before treatment(P<0.05),but there were no significant differences in the above indexes of the rehabilitation groups(P>0.05).The area,circumference and the anteroposterior diameter of pelvic and phrenic fissure in two groups were lower than those of before treatment(P<0.05),but there was no significant difference in the width of pubic rectum muscle between the two groups after treatment(P>0.05).The pubic rectum muscle in the rehabilitation group was better than that before treatment(P<0.05).The anteroposterior diameter,area,circumference and bladder neck mobility of the pelvic floor phrenic fissure(BND)of the rehabilitation group were significantly lower than those of before treatment(P<0.05).There were no significant differences in the above indexes in the observation group(P>0.05),and the above indexes in the rehabilitation group were significantly lower than those in the observation group after treatment(P<0.05).Conclusion:After the clinical scientific rehabilitation treatment,the pelvic floor structure and function of women with postpartum pelvic floor dysfunction can be effectively improved,and the application of transperineal three-dimensional ultrasound can effectively evaluate the rehabilitation treatment.