盆底三维超声在评估高龄产妇产后盆底功能障碍性疾病的临床研究

Pelvic Floor Tthree-dimensional Ultrasound Evaluating Postpartum Pelvic Floor Dysfunction in Elderly Parturient Women

目的探析对比盆底二维,三维超声评估高龄产妇产后早期盆底结构及功能的变化。方法选择玉溪市人民医院2021年7月至2023年1月就诊的产后早期(6~8周)高龄产妇86例作为观察组,选择同期就诊的产后早期适龄产妇50例作为对照组。所有研究对象均接受盆底二维、三维超声诊断;对比两组产妇盆底二维超声评估参数、三维超声评估参数;对比盆底二维、三维超声对适龄、高龄产妇产后盆底功能障碍性疾病(pelvic fIoor dysfunction,PFD)的诊断效能。结果观察组静息状态膀胱颈位置(bladder neck position,BNP)、膀胱尿道后角(Posterior urethravesical angel,PUA)、Valsalva动作BNP水平、膀胱颈移动度(bladder neck descent,BND)水平明显高于对照组(P<0.05)。观察组Valsalva动作肛提肌裂孔前后径(levator hiatal anteroposterior diameter,LHAP)、肛提肌裂孔左右径(levator hiatal lateral diameter,LHLP)、肛提肌裂孔面积(levator hiatal area,LHA)水平均明显高于对照组(P<0.05)。盆底三维超声诊断灵敏度(92.59%)、准确性(91.53%)明显高于二维超声(70.37%、77.91%,P<0.05)。结论高龄产妇产后早期更易出现盆底功能及结构变化,相较于二维超声,盆底三维超声更有助于提高PFD诊断效能。

Objective To explore the changes of pelvic floor structure and function in early postpartum period of elderly parturient women by two-dimensional and three-dimensional ultrasound.Method A total of 86 early postpartum(6-8 weeks)elderly parturients admitted to our hospital from July 2021 to January 2023 were selected as the observation group,and 50 early postpartum parturients admitted during the same period were selected as the control group.All study subjects underwent pelvic floor two-dimensional and three-dimensional ultrasound diagnosis.The two groups of maternal pelvic floor two-dimensional ultrasound evaluation parameters,three-dimensional ultrasound evaluation parameters were compared.The diagnostic efficacy of pelvic floor 2D and 3D ultrasound was compared for puerperal pelvic fIoor dysfunction(PFD)in women of appropriate age and advanced age.Result The observation group showed significantly higher levels of resting bladder neck position(BNP),posterior urethral angle(PUA),Valsalva maneuver BNP level,and bladder neck desent(BND)compared to the control group(P<0.05).Levator hiatal anteroposterior diameter(LHAP),levator hiatal lateral diameter(LHLP),and levator hiatal area(LHA)when performing Valsalva maneuver were significantly higher than that of the control group(P<0.05).The sensitivity and accuracy of pelvic floor three-dimensional ultrasound(92.59%)were significantly higher than those of two-dimensional ultrasound(70.37%,77.91%)(P<0.05).Conclusion Functional and structural changes of the pelvic floor are more likely to occur in older women in the early postpartum period.Compared with two-dimensional ultrasound,three-dimensional pelvic floor ultrasound is more helpful to improve the diagnostic efficiency of PFD.