经盆底三维超声成像技术在不同分娩方式产妇产后检查中的应用价值

Application Value of Three-dimensional Ultrasound Imaging through Pelvic Floor in Postpartum Examination of Different Delivery Modes

目的:研究经盆底三维超声成像技术在不同分娩方式产妇产后检查中的应用价值。方法:选择本院2019年3月-2020年3月接诊的300例产妇作为研究对象,其中自然分娩的150例为对照组,剖宫产的150例为观察组。两组产妇在产后6~8周均接受经盆底三维超声成像技术检查,比较两组分别在静息、缩肛、深呼吸-紧闭声门-用力呼气(Valsalva)时的肛提肌裂孔面积,超声测量指标(尿道旋转角度、膀胱颈下移距离、膀胱逼尿肌厚度),压力性尿失禁和盆腔器官脱垂情况。结果:观察组静息、缩肛、Valsalva时的肛提肌裂孔面积均显著小于对照组,尿道旋转角度、膀胱颈下移距离、膀胱逼尿肌厚度均显著小于对照组,差异均有统计学意义(P<0.05)。两组压力性尿失禁的发生率经比较差异无统计学意义(P>0.05),观察组盆腔器官脱垂的发生率(66.67%)显著高于对照组(33.33%),差异有统计学意义(P<0.05)。结论:自然分娩产妇的盆底结构、功能所受的损害远大于剖宫产产妇,经盆底维超声成像技术可以对产妇产后的盆底结构、功能进行早期判断。

Objective:To study the application value of pelvic floor three-dimensional ultrasound imaging technology in postpartum examination of different delivery methods.Method:A total of 300 cases of puerpera in our hospital from March 2019 to March 2020 were selected as the research objects.The patients with natural delivery were selected as the control group,the patients with cesarean section were selected as the observation group.The two groups of parturient women received pelvic floor three-dimensional ultrasound imaging at 6-8 weeks after delivery.The hiatus area of levator ani muscle was compared between the two groups at rest,anal contraction,deep breathing-glottic closing-forced expiratory(Valsalva),and the ultrasonic parameters(urethral rotation angle,bladder neck downward distance,bladder detrusor thickness),stress urinary incontinence and pelvic organ prolapse were compared between the two groups.Result:The area of levator ani hiatus in the observation group at rest,anal contraction and Valsalva were significantly smaller than those in the control group,and the urethral rotation angle,bladder neck downward displacement distance and bladder detrusor thickness in the observation group were significantly smaller than those in the control group(P<0.05).There was no significant difference in the incidence of stress urinary incontinence between the two groups(P>0.05).The incidence of pelvic organ prolapse in the observation group(66.67%)was significantly higher than 33.33%in the control group(P<0.05).Conclusion:The damage of pelvic floor structure and function of puerpera with natural childbirth is much greater than that of cesarean section.Pelvic floor dimensional ultrasound imaging technology can be used to early judge the structure and function of pelvic floor after delivery.