盆底超声在评估女性产后盆底结构及功能变化上的临床价值

Clinical value of transperineal ultrasound in evaluating the structural and functional changes of female postpartum pelvic floor

目的探讨盆底超声在评估女性产后盆底结构及功能变化上的临床价值。方法选取2018年12月至至2019年7月因产后42 d来我院行经会阴盆底超声检查的产妇153例。根据分娩方式和分娩次数将研究对象分为5组:自然分娩初产组45例,自然分娩二产组39例,自然分娩三产组11例,剖宫产初产组36例,剖宫产二产组22例。所有研究对象均在静息及Valsalva状态下检测并观察盆底各项参数指标。将各组参数指标进行统计学分析,组间平均数比较采用t检验;发生率的比较采用χ^(2)检验,定义P<0.05时差异具有统计学意义。结果自然分娩二产组的各项参数均大于自然分娩初产组,两组数据间差异均有统计学意义(P<0.05)。自然分娩三产组的BND、尿道旋转角、最大Valsalval状态时尿道倾斜角、膀胱后角、肛提肌裂孔面积均大于自然分娩二产组,两组数据间存在差异,且有统计学意义(P<0.05)。自然分娩初产组的最大Valsalval状态时膀胱后角明显大于剖宫产初产组(P<0.05),其他数据间差异均无统计学意义(P>0.05)。结论初次分娩时分娩方式对盆底机能影响不明显,分娩次数增多对盆底机能的近期影响较明显。

Objective To investigate the clinical value of transperineal ultrasound in evaluating the structural and functional changes of female postpartum pelvic floor. Methods The study enrolled 153 women underwent transperineal ultrasound on 42 days postpartum in our hospital from December 2018 to July 2019. According to the mode of delivery and the number of delivery, the subjects were divided into five groups: 45 cases in first-natural delivery group, 39 cases in second-natural delivery group, 11 cases in thirdnatural delivery group, 36 cases in first-cesarean section group and 22 cases in second-cesarean section group. The parameters of transperineal ultrasound were detected and observed in resting and Valsalva state. The parameters of each group were statistically analyzed. The mean between groups was compared by t test. The incidence was compared by χ^(2) test, and the difference was statistically significant when P < 0.05. Results The parameters of the second-natural delivery women were higher than those of the first-natural delivery women with significant differences(P < 0.05). The bladder neck descent(BND), urethral rotation angel, urethral tilt angle, retrovesical angle and the area of pelvic diaphragm hiatus of the third-natural delivery women were all wider than those of the second-natural delivery women, and differences were statistically significant(P < 0.05). The retrovesical angle of the first-natural delivery women were obviously wider than those of the first-cesarean delivery women, but the differences in the other parameters between the two groups were of no statistical significance(P > 0.05). Conclusions The effect of delivery mode on pelvic floor function is not obvious in the first delivery, but the short-term effect of delivery frequency on pelvic floor function is obvious.