盆底超声评估不同分娩方式对女性盆底结构和功能的影响

Pelvic Floor Ultrasound Evaluation of Different Delivery Methods on Female Pelvic Floor Structure and Function

目的观察盆底超声评估某三级医院不同分娩方式对女性盆底结构和功能的影响。方法分别选取2017年2月—2019年2月在我院就诊的产妇,按照不同分娩方式分为阴道分娩组和剖宫产组各40例。均在产妇产后6~8周采用彩色多普勒超声诊断仪器GE VolusonE8阴式探头行盆底超声检查,观察并测量产妇膀胱尿道后移动度(UVJ-M)、尿道膀胱连接部移动度(As、Ar)、肛直肠连接部距耻骨联合下缘距离(Ds、Dr)、膀胱颈距离耻骨联合下缘距离(ARJ-VD)等指标变化和盆腔器官脱垂情况。结果与阴道分娩组比较,剖宫产组产妇UVJ-M、As、Ar、Ds、Dr均降低(P均<0.05),剖宫产组产妇ARJ-VD增加(P<0.05)。剖宫产组盆腔器官脱垂发生比例低于阴道分娩组(P<0.05)。结论与阴道分娩相比,剖宫产分娩对盆底脏器影响较小。盆底超声检查有助于了解产妇分娩后盆底组织结构,值得临床推广。

Objective To observe the effect of different delivery methods on female pelvic floor structure and function in a tertiary hospital by pelvic floor ultrasound.Methods The pregnant women in our hospital from February 2017 to February 2019 were collected and divided into vaginal delivery group and cesarean section group with 40 cases in each group.After 6-8 weeks postpartum,the pelvic floor ultrasound was performed with GE volusonE8 negative probe.The retrourethral mobility(UVJ-M)and the urethral bladder junction mobility were observed and measured(As,Ar),distance between anorectal junction and lower edge of pubic symphysis(Ds,Dr),distance between bladder neck and pubic symphysis(ARJ-VD)and pelvic organ prolapse were compared.Results Compared with vaginal delivery group,UVJ-M,As,Ar,Ds,Dr in cesarean section group were decreased(P all<0.05),while ARJ-VD in cesarean section group was increased(P<0.05).The incidence of pelvic organ prolapse in cesarean section group was lower than that in vaginal delivery group(P<0.05).Conclusion Compared with vaginal delivery,cesarean section has little effect on pelvic floor organs.Pelvic floor ultrasound examination is helpful to understand the pelvic floor tissue structure of parturient after delivery.It has greater advantages and is worthy of clinical promotion.