盆底超声对产后妇女盆底功能障碍性疾病的早期诊断及临床价值

Early diagnosis and clinical value of pelvic floor ultrasound for pelvic floor dysfunction diseases in postpartum women

目的探讨盆底超声早期诊断产后妇女盆底功能障碍性疾病(PFD)的发生情况。方法选取2019年2月至2021年2月于本院进行超声检查的120例女性作为研究对象,其中盆底功能障碍性疾病自然分娩、剖腹产及健康未怀孕者各40例,分别作为A组、B组、C组,采用前瞻性队列研究的方法,比较3组PFD症状的发生情况及盆底解剖参数。结果A组尿失禁、直肠膨出及子宫脱垂盆底功能障碍性疾病症状的诊出率高于B组、C组,且B组高于C组,差异有统计学意义(P<0.05);盆底超声检查的真阳性率为92.13%;3组屏气向下用力动作(Valsalva动作)时膀胱后壁向阴道膨出距离、膀胱后角角度、直肠壶腹部向阴道膨出距离大于静息状态、缩肛动作状态,且静息状态大于缩肛动作状态,差异有统计学意义(P<0.05)。结论三维盆底超可提高盆底功能障碍性疾病诊断的准确性,值得在超声盆底检查中推广应用。

Objective To investigate the occurrence of pelvic floor dysfunction disease(PFD)in postpartum women with pelvic floor ultrasound.Methods 120 women from February 2019 to February 2021,including pelvic floor dysfunction natural delivery,caesarean section and healthy not pregnant 40 cases,as group A,groupB and group C,using the method of prospective cohort study,analyze and compare the occurrence of PFD symptoms and pelvic floor anatomy parameters.Results The diagnosis rate of urinary incontinence,rectocele and uterine prolapse of pelvic floor disorders in group A was higher than that in group B and C,and group B was higher than group C,the difference was statistically significant(P<0.05).The positive rate of pelvic floor ultrasonography was 92.13%.The distance from the posterior wall of the bladder to the vagina,the Angle of the posterior Angle of the bladder and the distance from the ampulla of the rectum to the vagina in breath-holding downward force action(Valsalva action)were greater than in the resting state and the anal retraction statein the three groups,and the resting state was greater than the anal retraction state,the difference was statistically significant(P<0.05).Conclusion Three-dimensional pelvic floor ultrasound can improve the accuracy of diagnosis of pelvic floor dysfunction and is worthy of popularization and application in ultrasonic pelvic floor examination.