超声检查对产后早期女性腹直肌及盆底结构与功能的观察与评估价值

Value of Ultrasonography in the Observation and Evaluation of Rectus Abdominis and Pelvic Floor Structure and Function in Early Postpartum Women

目的探讨超声检查对产后早期女性腹直肌及盆底结构与功能的观察与评估价值。方法收集2020年1~12月,体检健康且未育女性50例和初产妇100例,其中体检健康且未育女性纳入对照组,初产妇根据分娩方式的不同将经阴道顺产分娩的58例初产妇纳入顺产组,其余选择性进行剖宫产分娩的42例初产妇纳入剖宫产组。所有受检者均给予经会阴盆底超声检查,对比3组在不同状态下的超声参数及腹直肌差异。结果静息状态下,各组PUA和UTA比较不存在统计学差异(P>0.05);但顺产组CMP、BNP小于剖宫产组和对照组,且剖宫产组BNP小于对照组(P<0.05);最大Valsalva状态下,各组PUA比较不存在统计学差异(P>0.05),但顺产组UTA大于剖宫产组和对照组,CMP、BNP小于剖宫产组和对照组,两两对比显示,剖宫产组UTA大于对照组,CMP、BNP小于对照组,上述指标相比(P<0.05);顺产组URA、CDD、BND均大于对照组,但顺产组仅在URA、CDD上大于剖宫产组(P<0.05)。结论经阴道分娩初产妇的盆底结构与功能损伤较剖宫产更严重,采用超声检查能动态观察产后早期女性腹直肌与盆腔脏器的形态变化,有利于尽快检出盆底功能障碍并干预。

Objective To investigate the value of ultrasonography in the observation and evaluation of rectus abdominis and pelvic floor structure and function in early postpartum women.Methods From January 2020 to December 2020,50 healthy women without childbirth and 100 primiparas were collected.Among them,healthy women without childbirth were included in the control group.58 primiparas who delivered by vaginal delivery were included in the natural delivery group according to the different delivery modes,and 42 primiparas who delivered by cesarean section were included in the cesarean section group.All the subjects were given transperineal pelvic floor ultrasound examination,and the differences of ultrasound parameters and rectus abdominis in different states were compared among the three groups.Results At rest,there was no significant difference in PUA and UTA among the groups(P>0.05);However,the CMP and BNP of the spontaneous delivery group were lower than those of the cesarean section group and the control group,and the BNP of the cesarean section group was lower than that of the control group(P<0.05);Under the maximum Valsalva state,there was no significant difference in PUA among the groups(P>0.05),but UTA in the spontaneous delivery group was higher than that in the cesarean section group and the control group,while CMP and BNP were lower than those in the cesarean section group and the control group.Pairwise comparison showed that UTA in the cesarean section group was higher than that in the control group,while CMP and BNP in the cesarean section group were lower than those in the control group(P<0.05);The URA,CDD and BND of the natural labor group were higher than those of the control group,but only URA and CDD of the natural labor group were higher than those of the cesarean section group(P<0.05).Conclusion The damage of pelvic floor structure and function in vaginal delivery women is more serious than that in cesarean section.Ultrasound can dynamically observe the morphological changes of rectus abdominis and pelvic organs in early postpartum women,which is conducive to detect pelvic floor dysfunction as soon as possible and timely intervention.