经会阴三维超声评估分娩对肛提肌的影响

Effect of evaluation of delivery by transperineal three-dimensional ultrasound on levator ani muscle

目的应用经会阴三维超声评估初产妇及未育女性肛提肌裂孔面积和肛提肌厚度的变化,探讨妊娠分娩对肛提肌裂孔面积及肛提肌厚度和收缩功能的影响。方法选择2017年12月～2018年11月产后6～8周检查的首次经阴道分娩产妇50例为产后组,同期选取健康未育女性41名为对照组。应用经会阴三维超声测量静息及最大收缩状态下肛提肌裂孔面积及左右两侧肛提肌的厚度,并进行比较。结果产后组静息状态及最大收缩状态下肛提肌裂孔面积分别为(12.52±1.98)cm^2和(10.47±1.47)cm^2,均较对照组大,差异有统计学意义(P<0.01)。产后组静息状态及最大收缩状态下肛提肌厚度左侧分别为(0.58±0.11)cm和(0.77±0.12)cm,右侧分别为(0.58±0.09)cm和(0.76±0.11)cm,均较对照组小,差异有统计学意义(P<0.001)。结论妊娠及经阴道分娩对肛提肌存在一定损伤,经会阴三维超声可较为客观地评价肛提肌的收缩功能。

Objective To use transperineal three-dimensional ultrasonography to evaluate the changes of hiatus area and thickness of levator ani muscle in primipara and infertile women,so as to investigate the effect of pregnancy and delivery on the hiatus area,thickness and contractile function of levator ani muscle.Methods From December 2017 to November 2018,50 parturients with the first vaginal delivery were selected as postpartum group,and 41 healthy infertile women were selected as control group during the same period.The hiatus area and the thickness of levator ani muscle at resting state and maximum contraction state were measured by transperineal three-dimensional ultrasound,and then the results were compared.Results The hiatus areas of levator ani muscle in resting state and maximum contraction state in the postpartum group were(12.52±1.98)cm^2 and(10.47±1.47)cm^2 respectively,which were larger than those in the control group,difference was statistically significant(P<0.01).And the thickness of left levator ani muscle at resting state and maximum contraction state in the postpartum group were(0.58±0.11)cm and(0.77±0.12)cm respectively,and those of right levator ani muscle were(0.58±0.09)cm and(0.76±0.11)cm respectively,all of them were smaller than those of the control group,difference was statistically significant(P<0.001).Conclusion Pregnancy and vaginal delivery have some damage to the levator ani muscle,and the contractile function of the levator ani muscle can be evaluated objectively by transperineal three-dimensional ultrasonography.