经会阴三维超声对产钳助产术后肛提肌和肛门括约肌损伤的评估

Evaluation of forceps assisted delivery on the levator ani muscle and anal sphincter injuries by three-dimensional transperineal ultrasound

目的应用经会阴三维超声评价产钳助产对肛提肌和肛门括约肌损伤的影响。方法选取61例产钳助产术后患者(研究组)和60例同期正常经阴道分娩患者(对照组),回顾分析其经会阴三维超声容积数据,比较两组肛提肌和肛门括约肌损伤的发生率。结果研究组和对照组肛提肌撕裂发生率分别为45.90%和8.33%,差异有统计学意义(P<0.01);肛提肌裂孔增大发生率分别为40.98%和43.33%,差异无统计学意义;肛门括约肌损伤发生率分别为22.95%和8.33%,差异有统计学意义(P<0.05)。结论产钳助产术后产妇肛提肌撕裂和肛门括约肌损伤发生率高,临床应关注产钳助产导致的盆底损伤。

Objective To evaluate the impact of forceps assisted delivery on levator ani and anal sphincter injury by three-dimensional transperineal ultrasound.Methods Sixty-one women with forceps assisted delivery and 60 women with normal vaginal delivery were collected in the research group and the control group.Data of transperineal three-dimensional ultrasound volume of both groups were recorded and analyzed retrospectively.The incidence of levator ani injury and anal sphincter injury were compared.Results The incidence of levator ani avulsion,anal sphincter injury in the research group and the control group were 45.90% and 8.33%,22.95% and 8.33%,respectively,with statistically significant difference between two groups(both P<0.01).The incidence of levator ani hiatus enlargement in research goup and control group were 40.98% and 43.33%,respectively,there was no significant difference between two groups.Conclusion The incidence of levator ani avulsion and anal sphincter injuries after forceps assisted delivery is significantly high.The pelvic floor injury caused by forceps should be paid attention to in clinical practice.