三维盆底超声在不同BMI及孕周产妇盆底功能评估中的价值

Value of three-dimensional pelvic floor ultrasound in evaluation of pelvic floor function in women with different BMI and gestational weeks

目的研究三维盆底超声评估不同体质量指数(BMI)及不同孕周产妇盆底功能的价值。方法选取2016年8月至2019年8月在该院产科进行孕期检查的孕妇120例作为研究对象,按照其孕期初次检查的BMI水平将其分为A、B、C 3组,分别于孕早、中、晚期对3组患者进行三维盆底超声检查,测量肛提肌裂孔面积、膀胱下移距离、尿道旋转角度及逼尿肌厚度,并根据图像显示观察有无器官脱垂(POP)并测量POP距离。结果C组孕中、晚期POP例数(14例vs.19例)及距离[(3.97±0.65)mm vs.(5.28±1.09)mm]明显高于孕早期及A、B组孕中、晚期,差异有统计学意义(P<0.05)。C组孕中、晚期静息、收缩及Valsalva动作时肛提肌裂孔面积明显大于孕早期及A、B组孕中、晚期,差异有统计学意义(P<0.05)。C组孕中、晚期膀胱颈下移距离、尿道旋转角度、逼尿肌厚度均明显高于孕早期及A、B组孕中、晚期,差异有统计学意义(P<0.05)。结论三维盆底超声检查对不同BMI及孕周产妇的盆底功能的评估较为清晰准确,临床价值较高。

Objective To study the value of three-dimensional pelvic floor ultrasound in evaluating pelvic floor function of pregnant women with different body mass index(BMI)and gestational weeks.Methods 120 pregnant women who underwent prenatal examination in obstetrics department of our hospital from August 2016 to August 2019 were selected as the research objects.According to the BMI index of their first pregnant examination,they were divided into three groups:A,B and C.Three-dimensional pelvic floor ultrasonography was performed in three groups at the early,middle and late stages of pregnancy.The area of levator ani hiatus,the distance of bladder descent,the angle of urethral rotation and the thickness of detrusor muscle were measured.The organ prolapse(POP)was observed and the distance of POP was measured according to the image display.Results The cases in the middle and late pregnancy(14 vs.19)and distance[(3.97±0.65)mm vs.(5.28±1.09)mm]of POP in group C were significantly higher than those in group A and B(P<0.05).In group C,the area of levator ani muscle hiatus during rest,contraction and Valsalva maneuver in the middle and late pregnancy was significantly larger than that in early pregnancy and mid-late pregnancy in group A and B(P<0.05).The distance of bladder neck descending,the angle of urethral rotation and the thickness of detrusor muscle in group C were significantly higher than those in group A and B in the middle and late pregnancy(P<0.05).Conclusion Three-dimensional pelvic floor ultrasonography has a clear and accurate evaluation of pelvic floor function for women with different BMI and gestational weeks,and has a high clinical value.