超声动态观察产后盆底结构变化及监测尿失禁的临床价值研究

Dynamic observation of postpartum pelvic floor structure changes by ultrasound and its clinical value of urinary incontinence monitoring

目的:应用三维超声检测产后女性盆底的形态结构,为产后尿失禁的诊治提供影像学证据。方法:选取340例产妇为研究对象,行三维盆底超声检查,观察并记录在静息和缩肛状态下盆底的形态结构参数,分析上述参数与尿失禁的相关性。结果:340例中,尿失禁65例,发生率为19.12%;在发生会阴裂伤及尿道内口未关闭产妇中,尿失禁的发生率均明显上升(均P<0.001);尿失禁产妇分娩的婴儿体质量明显高于无尿失禁产妇(P<0.001);尿失禁产妇Valsalva-尿道倾斜角明显低于无尿失禁产妇(P<0.001)。结论:经会阴超声检查可观察女性产后盆底结构的变化,为产后盆底功能障碍监测提供可靠的影像学资料;临床实践中,应将有会阴裂伤、尿道口未关闭的产妇作为重点观察对象。

Objective:To detect the morphological structure of postpartum female pelvic floor by three-dimensional ultrasound,and to provide imaging evidence for the diagnosis and treatment of postpartum urinary incontinence. Methods:A total of 340 women who gave birth in the obstetrics in our hospital were selected. Three-dimensional pelvic floor ultrasound examination was performed on them. The morphological and structural parameters of the pelvic floor were observed and recorded under resting and contracted anal conditions. The correlation between the parameters and urinary incontinence were analyzed. Results:Among the 340 pregnant women included in the study,65 cases of urinary incontinence occurred after delivery,the incidence rate was 19.12%;in the women with tear,the incidence of urinary incontinence increased significantly(P<0.001);in the urethra among the women who had not closed,the incidence of urinary incontinence increased significantly(P<0.001);the weight of the babies whose mothers had urinary incontinence was significantly higher than that of the women without urinary incontinence(P<0.001);the valsalva-urethral tilt angle of the mothers who had urinary incontinence was significantly lower than that of women without urinary incontinence(P<0.001). Conclusions:Perineal ultrasonography can be used to observe changes in postpartum pelvic floor structure in women,and provide reliable imaging data for postpartum pelvic floor dysfunction monitoring. In clinical practice,women with tears and urethral opening should be the focus of observation.