实时剪切波弹性成像联合经阴四维超声在自然分娩初产妇产后盆底功能评估中的应用

Application of Real Time Shear Wave Elastography Combined with Transvaginal Four-Dimensional Ultrasound in the Evaluation of Pelvic Floor Function of Primiparas After Natural Delivery

目的分析实时剪切波弹性成像(SWE)联合经阴四维超声对自然分娩初产妇产后盆底功能的评估价值。方法选取2018年2月至2021年6月于许昌市人民医院自然分娩的110例初产妇作为研究对象,所有产妇均于产后6周接受SWE联合经阴四维超声检查。统计所有产妇产后6周盆底功能障碍情况,分析SWE联合经阴四维超声对自然分娩初产妇产后盆底功能障碍的评估价值。结果产后6周,110例自然分娩初产妇中发生盆底功能障碍21例,盆底功能正常89例。盆底功能障碍组膀胱颈活动度、静息状态下肛提肌裂孔面积(LHA)与最大Valsalva动作状态LHA值均高于盆底功能正常组,差异有统计学意义(P<0.05)。绘制受试者工作特征曲线,结果显示,膀胱颈活动度、静息状态下LHA、最大Valsalva状态LHA单独及联合评估自然分娩初产妇产后盆底功能障碍的曲线下面积均>0.7,具有一定评估价值,联合评估效果最佳。结论SWE联合经阴四维超声评估自然分娩初产妇产后盆底功能障碍的价值较高。

Objective To analyze the value of real time shear wave elastography(SWE)combined with transvaginal four-dimensional ultrasound in the evaluation of pelvic floor function of primiparas after natural delivery.Methods A total of 110 primiparas with natural delivery admitted to Xuchang People’s Hospital from February 2018 to June 2021 were selected as the research subjects.All parturients underwent SWE combined with transvaginal four-dimensional ultrasound 6 weeks after delivery.The pelvic floor dysfunction of all parturients 6 weeks after delivery was counted,and the value of SWE combined with transvaginal four-dimensional ultrasound in the evaluation of pelvic floor dysfunction after natural delivery was analyzed.Results Six weeks after delivery,among 110 primiparas who delivered naturally,21 had pelvic floor dysfunction and 89 had normal pelvic floor function.The activity of bladder neck,levator hiatus area(LHA)in resting state and the LHA in maximum Valsalva action state in pelvic floor dysfunction group were higher than those in normal pelvic floor function group(P<0.05).The receiver operating characteristic curve was drawn.The results showed that,area under the curve of bladder neck activity,LHA in resting state,LHA in maximum Valsalva state alone and combined in the evaluation of pelvic floor dysfunction after primiparas in natural delivery were all>0.7,which represented certain evaluation value.The joint evaluation effect was the best.Conclusion SWE combined with transvaginal four-dimensional ultrasound is of high value in evaluating pelvic floor dysfunction in primiparas after natural delivery.