三维超声成像技术在产后早期盆底结构评估中的应用价值

Application of three-dimensional ultrasound imaging in pelvic floor structural assessment in early postpartum period

目的探讨三维超声成像技术在产后早期盆底结构评估中的应用效果。方法选取我院分娩的180例初产妇为观察对象,其中阴道分娩130例、剖宫产50例。均于产后6~8周时经会阴实时三维超声成像技术检查。另选取50例未生育的健康体检女性为对照组,行经会阴实时三维超声成像技术检查。观察该组产妇及对照组在盆底平静状态和压力状态下的图像特征,包括肛提肌裂孔的左右径、前后径和面积等指标。结果阴道分娩组、剖宫产组、对照组在静息和Valsalva状态下的肛提肌裂孔的左右径、前后径和面积的差异均呈现统计学意义(P<0.05)。阴道分娩组、剖宫产组、对照组在静息和Valsalva状态下的左右两侧耻骨直肠肌厚度的差异均呈现统计学意义(P<0.05)。阴道分娩组、剖宫产组、对照组的膀胱颈移动度的差异有统计学意义(P<0.05)。结论三维超声成像技术能够为产后盆底功能诊断提供解剖学和功能信息,在产后盆底功能障碍的诊断中有较好的临床应用价值。

Objective To investigate the effect of three-dimensional ultrasound imaging in early pelvic floor structure assessment after delivery.Methods 180 cases of primipara delivered in our hospital from August to December 2018 were selected as the research objects,including 130 cases of vaginal delivery and 50 cases of cesarean section.All cases were examined by real-time three-dimensional ultrasound imaging of perineum at 6~8 weeks postpartum.Another 50 healthy women who had not given birth were selected as the study subjects(control group).They were examined by real-time three-dimensional ultrasound imaging of perineum.The image characteristics of the puerpera and the control group in the pelvic floor quiet state and pressure state were observed,including the left and right diameters,anterior and posterior diameters and area of levator ani fissure.Results There were significant differences in the left and right diameters,anterior and posterior diameters and areas of levator ani muscle hiatus between vaginal delivery group,cesarean section group and control group in resting and Valsalva state(P<0.05).The difference of puborectal muscle thickness between the left and right sides of vaginal delivery group,cesarean section group and control group in resting and Valsalva state was statistically significant(P<0.05).There were significant differences in bladder neck mobility among vaginal delivery group,cesarean section group and control group(P<0.05).Conclusion Three-dimensional ultrasound imaging can provide anatomical and functional information for the diagnosis of postpartum pelvic floor dysfunction,and has a good clinical value in the diagnosis of postpartum pelvic floor dysfunction.