SWE对不同分度中盆腔器官脱垂初产妇髂尾肌弹性的评估

SWE evaluates elasticity of iliococcygeal muscle in primiparas with different degrees of middle pelvic organ prolapse

目的利用剪切波弹性成像(shear wave elastography,SWE)技术评估POP-Q不同分度中盆腔器官脱垂初产妇髂尾肌的弹性变化,探讨SWE在中盆腔器官脱垂中的应用价值。方法选取2020年1月~2020年12月健康初产妇32例作为A组;同期POP-QⅠ级中盆腔器官脱垂初产妇35例为B组;同期POP-QⅣ级中盆腔器官脱垂初产妇31例为C组。应用剪切波弹性成像技术分别在静息和缩肛状态下测量各组髂尾肌的杨氏模量值。结果A、B、C三组在缩肛状态下髂尾肌的杨氏模量值均较静息状态增大,差异有统计学意义(P均<0.05)。B组及C组于静息状态下髂尾肌杨氏模量值较同状态下A组杨氏模量值增大,且C组>B组,差异有统计学意义(P<0.05),A组于缩肛状态下髂尾肌杨氏模量值与较同状态下B组及C组增大,且B组>C组,差异有统计学意义(P<0.05)。结论SWE可以作为一种无创定量方法评估盆底肌肉的生物力学特性,为深入了解盆腔器官脱垂提供一定的理论基础。

Objective To evaluate the elasticity of iliococcygeal muscle in middle pelvic organ prolapse primiparas of different POP-Q scales using Shear wave elastography(SWE),and to explore the value of SWE in middle pelvic organ prolapse.Methods32 healthy primiparas from January 2020 to December 2020 were collected as group A;from the same period,35 primiparas with POP-QⅠgrade of middle pelvic organ prolapse were assigned to group B.31 primiparas with POP-QⅣgrade of middle pelvic organ prolapse were allocated to group C.SWE was used to measure the Young's modulus of iliococcygeal muscle in each group under the resting and shrinking anal state.Results Young's modulus of shrinking anal state in each group was higher than that of resting state,and the difference was statistically significant(all P<0.05).Young's modulus of iliococcygeal muscle in group B and group C at resting state was higher than that in group A at the same state,and that in group C>group B,the difference was statistically significant(P<0.05).Young's modulus of iliococcygeal muscle in group A at shrinking anal state was higher than that in group B and group C under the same state,and group B>group C,the difference was statistically significant(P<0.05).Conclusion SWE can be used as a non-invasive quantitative method to evaluate the biomechanical properties of pelvic floor muscles and provide some help for understanding pelvic organ prolapse.