经会阴四维超声成像检测产后盆底功能障碍性疾病的应用价值

Application value of transperineal four-dimensional ultrasound in postpartum pelvic floor dysfunction

目的探讨经会阴四维超声成像检测产后盆底功能障碍性疾病(PFD)的应用价值。方法选取产后PFD患者84例(A组)和同期产后无PFD者80例(B组),于会阴正中矢状切面行静息和Valsalva动作状态下经会阴四维超声成像检查,测量盆膈裂孔前后径(LHAP)、左右径(LHLR)、面积(LHA)及左、右肛提肌厚度;分析经会阴四维超声成像对PFD的诊断效能。结果 A组静息和Valsalva动作状态下盆膈裂孔LHAP、LHLR、LHA及左、右肛提肌厚度均明显高于B组,差异均有统计学意义(均P<0.05);经会阴四维超声成像诊断产后PFD的敏感性、特异性及准确性分别为95.24%、92.50%及93.90%。结论经会阴四维超声成像检查盆膈裂孔及肛提肌形态学特征有利于及早发现产后PFD,具有较好的临床应用价值。

Objective To explore the application value of transperineal four-dimensional ultrasound in postpartum pelvic floor dysfunction(PFD).Methods Eighty-four puerpera with postpartum PFD were selected in group A,80 puerpera without postpartum PFD were selected in group B at the same time.All puerperas were underwent transperineal four-dimensional ultrasound under the rest and Valsalva state,the levator hiatal area(LHA),levator hiatal lateral pathway(LHLP),levator hiatal anteroposterior pathway(LHAP)and left,righ levator thickness were measured.Results LHAP,LHLR,LHA and left,right levator thickness of group A under rest and Valsalve state were significantly higher than those of group B(all P<0.05).The sensitivity,specificity and accuracy of diagnosing postpartum PFD by transperineal four-dimensional ultrasound were 95.24%,92.50%,93.90%,respectively.Conclusion The diaphragmatic hiatus and anal muscle morphological features are checked by transperineal four-dimensional ultrasound,which is conducive to accurately identify postpartum PFD as early as possible.