二胎政策下超声测量产后腹直肌分离的应用效果及临床价值

The application effect and clinical significance of ultrasound in the measurement of diastasis recti abdominis after parturition under the policy of two fetus

目的探析二胎政策下超声测量产后腹直肌分离的应用效果及临床价值,为患者的恢复提供临床指导。方法选择2019年10月—2020年4月本院妇保科就诊的100例首胎及二胎包括顺产及剖宫产产前孕28周及产后6~8周的产妇作为研究对象,采用随机数表法分为实验组和对照组两组,每组各100例。实验组应用超声测量产后腹直肌分离法,对照组应用传统腹直肌分离腹部触诊法。记录两种不同测量方法的腹直肌分离(DRA)距离、妊娠期及产后DRA漏诊率及阳性检出率,并进行分析研究。结果实验组患者漏诊率(2.00%)明显低于对照组(14.00%),差异有统计学意义(P<0.05);实验组患者阳性检出率(50.00%)明显高于对照组(36.00%),差异有统计学意义(P<0.05)。两组患者在孕28周、孕32周DRA距离比较,差异无统计学意义(P>0.05);实验组患者在孕35周、孕37周、产后1周、产后2周、产后3周DRA距离明显小于对照组,差异有统计学意义(P<0.05);两组患者在产后4周、产后5周DRA距离比较,差异无统计学意义(P>0.05)。结论二胎政策下超声测量产后腹直肌分离,有利于早期发现和准确诊断腹直肌分离情况,做到及早预防及时治疗,可有效降低漏诊率,提高阳性诊出率,具有临床应用价值,值得推广。

Objective To study the application effect and clinical value of ultrasound in the measurement of diastasis recti abdominis(DRA)after parturition under the two-child policy,and to provide clinical guidance for the recovery of patients.Methods 100 cases of primiparity women and women with second child(including natural delivery and cesarean section,28 weeks of gestation before delivery and 6-8 weeks after delivery)those admitted to women health section of our hospital from October 2019 to April 2020 were enrolled as study subjects.According random number method,they were divided into experimental group and control group,100 in each group.The DRA was detected by ultrasonic method in experimental group,while the abdominal palpation method was applied in the control group.The distance of DRA measured by both two methods,the misdiagnose rate and positive detection rate of DRA in pregnant and postpartum period were recorded.Results The missed diagnosis rate of the experimental group was 2.0%,which was significantly lower than 14.0%of the control group,with statistically significance(P<0.05).The positive rate of the experimental group was 50.0%,which was significantly higher than that of the control group(36.0%)(P<0.05).There was no significant difference in DRA distance between the two groups at 28th week and 32th week of pregnancy(P>0.05).In the experimental group,the separation distances of DRA at 35th and 37th week of gestation,and at 1st,2nd and 3rd week after delivery were significantly shorter than those in the control group(P<0.05).There was no significance in the distances of DRA at 4th and 5th week after delivery between the two groups(P>0.05).Conclusions The ultrasonic measurement of the DRA under the two-child policy is conducive to the early detection and accurate diagnosis of the DRA,could achieve early prevention and timely treatment,effectively reduce the missed diagnosis rate and improve the positive diagnosis rate,which has clinical application value and is worth popularizing.