盆底超声检查和盆底肌力对阴道分娩与剖宫产女性盆底功能的评估价值

Value of Pelvic Floor Ultrasound and Pelvic Floor Muscle Strength in Evaluating Pelvic Floor Function in Women with Vaginal Delivery and Cesarean Section

目的:探究盆底超声检查和盆底肌力对阴道分娩与剖宫产女性盆底功能的评估价值。方法:选取2019年2月-2021年2月本院90例阴道顺产产妇作为阴道顺产组,90例剖宫产产妇作为剖宫产组。另选取同期于本院体检的未生育健康女性90例为对照组。三组均行盆底超声检查与盆底肌力检查,比较三组静息、Valsalva、缩肛状态下肛提肌裂孔(面积、左右径、前后径)、肛提肌厚度(左侧、右侧);比较三组静息膀胱角度、Valsalva膀胱角度、膀胱颈活动度、膀胱颈移动度、Ⅰ类肌持续收缩力与Ⅱ类肌最大收缩力度。结果:阴道顺产组和剖宫产组静息、Valsalva、缩肛状态下肛提肌裂孔(面积、左右径、前后径)、肛提肌厚度(左侧、右侧)和静息膀胱角度、Valsalva膀胱角度、膀胱颈活动度、膀胱颈移动度均大于对照组,且阴道顺产组均大于剖宫产组(P<0.05)。阴道顺产组Ⅰ类肌持续收缩力、Ⅱ类肌最大收缩力度均小于剖宫产组与对照组(P<0.05),但剖宫产组与对照组比较,差异均无统计学意义(P>0.05)。结论:盆底超声检查和盆底肌力可有效评估阴道分娩与剖宫产女性盆底功能,为早期发现盆底功能异常提供可观影像依据。

Objective:To explore the value of pelvic floor ultrasound and pelvic floor muscle strength in evaluating the pelvic floor function of vaginal delivery and cesarean section women.Method:Ninety cases of vaginal vaginal delivery in our hospital from February 2019 to February 2021 were selected as the vaginal vaginal delivery group,and 90 cases of cesarean delivery were selected as the cesarean delivery group.Another 90 healthy women without childbirth history underwent physical examination in our hospital during the same period were selected as the control group.Pelvic floor ultrasonic examination and pelvic floor muscle strength examination were performed in all three groups.The levator ani hiatus(area,left and right diameter,anterior and posterior diameter),levator ani muscle thickness(left and right)were compared among the three groups in the state of rest,Valsalva and retraction of the anus.The rest bladder angle,Valsalva bladder angle,bladder neck activity,bladder neck mobility,continuous muscle contraction force of classⅠand maximum muscle contraction force of classⅡwere compared among three groups.Result:The levator ani hiatus(area,left and right diameter,anterior and posterior diameter),levator ani muscle thickness(left and right)in the state of rest,Valsalva and retraction of the anus,rest bladder angle,Valsalva bladder angle,bladder neck activity,bladder neck mobility in vaginal delivery group and cesarean section group were higher than those in control group,and vaginal delivery group were higher than cesarean section group(P<0.05).The continuous contractile force of typeⅠmuscle and the maximum contraction strength of typeⅡmuscle in vaginal delivery group were less than those in cesarean section group and control group(P<0.05),but there was no significant difference between cesarean section group and control group(P>0.05).Conclusion:Pelvic floor ultrasound and pelvic floor muscle strength can effectively evaluate the pelvic floor function of women in vaginal delivery and cesarean section,and provide considerable imaging basis for early detection of pelvic floor dysfunction.