产后腹直肌分离的超声检查特点及腹直肌分离的影响因素

Ultrasonographic Characteristics of Postpartum Diastasis Recti Abdominis and Its Influencing Factors

目的:探讨产后腹直肌分离(diastasis recti abdominis,DRA)的超声检查特点,并分析DRA的影响因素。方法:纳入某院2020年3月-2021年12月的进行产检及分娩共152例为观察组,同时纳入正常分娩无DRA的受试者38例为对照组,所有产妇均在产后42d进行超声检查。观察超声检查观察组的DRA超声特点,统计两组受试者的腹直肌间距(脐下3cm、脐部和脐上3cm)、提肛肌裂孔面积,观察两组受试者的产妇年龄≥35岁、分娩方式(自然分娩、剖宫产分娩)、分娩次数、新生儿出生体质量、孕期体质量、产妇身高;并采用Logistics回归分析观察产后DRA的影响因素。结果:158例产妇中,经超声检查发现:腹中线增宽128例、腹中线连续性中断24例;高低不等回声21例、窄带样中强回声62例、纤维样略强回声69例。观察组产妇腹直肌间距、提肛肌裂孔面积均大于对照组,对比差异具有统计学意义(P<0.05)。观察组产妇年龄≥35岁、分娩方式中剖宫产分娩人数均多于对照组(P<0.05),对比差异具有统计学意义;观察组产妇分娩次数、新生儿出生体质量和孕期体质量均多于对照组(P<0.05),对比差异具有统计学意义;两组产妇身高对比差异无统计学意义(P>0.05)。经Logistics回归分析发现:年龄≥35岁、分娩次数(多次)、孕期体质量、分娩方式(剖宫产)均为DRA发生的危险因素(P<0.05),差异具有统计学意义。结论:产后DRA超声特点为腹中线增宽,回声增强,产妇腹直肌间距、提肛肌裂孔面积均大于正常产妇,年龄≥35岁、分娩次数(多次)、孕期体质量、分娩方式(剖宫产)均为DRA发生的危险因素。

Objective:To investigate the ultrasonographic characteristics of postpartum diastasis recti abdominis(diastasis recti abdominis,DRA),and to analyze the influencing factors of DRA.Methods:A total of 152 cases of obstetric examination and delivery in a hospital from March 2020 to December 2021 were included as the observation group,38 normal delivery subjects without DRA were included as the control group,and all puerperae underwent ultrasound examination at 42d after delivery.The DRA ultrasound characteristics of the observation group were observed;The distance between the rectus abdominis(3 cm below the umbilicus,3 cm above the umbilicus)and the levator hiatus area of the two groups of subjects were observed;The maternal age≥35 years old,mode of delivery(natural delivery,cesarean section),number of deliveries,birth weight of newborns,weight during pregnancy,and maternal height of the two groups of subjects were observed.Logistic regression analysis was used to observe the influencing factors of postpartum DRA.Results:Among the 158 puerperae,ultrasonography examination found that abdominal there were 128 cases of abdominal midline widening,24 cases of abdominal midline discontinuity,21 cases of high and low echoes,62 cases of narrow-band strong echoes,and 69 cases of fibrous slightly strong echoes.The distance between rectus abdominis and the levator hiatus area in the observation group were larger than those in the control group,and the difference was statistically significant(P<0.05).The puerperae with age≥35 years old and the number of cesarean deliveries in the observation group were more than those in the control group(P<0.05),and the difference was statistically significant(P<0.05).The number of deliveries,birth weight of newborns,and weight during pregnancy in the observation group were more than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the height of puerperae between the two groups(P>0.05).The Logistic regression analysis showed that all of age≥35 years old,number of deliveries(multiple times),body weight during pregnancy,and mode of delivery(cesarean section)were risk factors for DRA(P<0.05),and the difference was statistically significant.Conclusion:The characteristics of postpartum DRA ultrasound are widened abdominal midline,enhanced echo,and larger distance between rectus abdominis and levator hiatus area of puerperae than those of normal puerpera.All of age≥35 years old,number of deliveries(multiple times),body weight during pregnancy,and mode of delivery(cesarean section)are risk factors for DRA.