产后早期经会阴盆底四维超声对前盆腔功能障碍的评估价值分析

Clinical significance of four-dimensional ultrasound through perineal pelvic floor in early postpartum period for anterior pelvic dysfunction

目的探讨产后早期经会阴盆底四维超声对前盆腔功能障碍的评估价值。方法选择2020年1月—2020年12月于惠东县人民医院产科经阴道分娩的产后6周复查的100例初产妇,入选者均行超声检查,根据超声检查结果分为前盆腔功能障碍组与非障碍组。比较2组最大尿道内口形成率、膀胱颈旋转角、尿道膀胱后角(PUA)、膀胱颈至耻骨联合中点的距离、膀胱颈移动度(BND)、不同状态下盆隔裂孔等数值。结果100例初产妇经超声检查,有58例出现前盆腔功能障碍;前盆腔功能障碍组最大尿道内口形成率为24.14%(14/58),高于正常组的4.76%(2/42);前盆腔功能障碍组膀胱颈旋转角(54.29±8.46)°、PUA(138.76±14.35)°、BND(28.64±4.73)mm均高于正常组的(40.12±4.55)°、(105.23±7.96)°、(14.53±3.02)mm;前盆腔功能障碍组静息状态、Valsalva动作下盆隔裂孔前后径、面积均大于正常组,差异有统计学意义(P<0.05)。结论前盆腔功能障碍产后早期经会阴盆底四维超声检查能够准确评估盆腔结构与功能状态,为临床治疗提供参考信息。

Objective To explore the evaluation value of perineal pelvic floor four-dimensional ultrasound in the early postpartum period for anterior pelvic dysfunction.Methods A total of 100 primiparas who had undergone a 6-week postpartum review in the obstetrics department of the Hospital between January 2020 and December 2020 were enrolled.All patients enrolled were examined by ultrasound.According to the ultrasound examination results,they were divided into an anterior pelvic dysfunction group and a non-disorder group.The maximum formation rate of urethral orifice,bladder neck rotation angle,posterior urethral bladder angle(PUA),distance from bladder neck to pubic symphysis midpoint,bladder neck mobility(BND),pelvic septal hiatus under different conditions were compared between the two groups.Results Among the 100 primiparas undergone ultrasound examinations,58 cases developed anterior pelvic dysfunction;the maximum urethral orifice formation rate of the anterior pelvic dysfunction group was 24.14%(14/58),higher than that in the normal group,which was 4.76%(2/42).The bladder neck rotation angle,PUA and BND in the dysfunction group were respectively(54.29±8.46)°,(138.76±14.35)°,and(28.64±4.73)mm,all shown to be higher than those in the normal group,which were(40.12±4.55)°,(105.23±7.96)°and(14.53±3.02)mm.The anteroposterior diameter and area of the pelvic septal hiatus under the resting state and Valsalva maneuver were larger than the normal group,and the difference was statistically significant(P<0.05).Conclusion The four-dimensional ultrasonography through the perineal pelvic floor in the early postpartum period of anterior pelvic dysfunction can accurately assess the pelvic structure and function status,thus provide a reference for its clinical treatment.