超声剪切波弹性成像联合盆底超声检查对阴道分娩产妇盆底功能障碍的诊断效能分析

Analysis of diagnostic efficacy of ultrasonic shear wave elastography combined with pelvic floor ultrasound in pelvic floor dysfunction of parturients with vaginal delivery

目的探讨超声剪切波弹性成像(shear wave elastography,SWE)联合盆底超声检查对阴道分娩产妇盆底功能障碍的诊断效能。方法选择2020年9月至2021年12月河北省秦皇岛市第一医院收治的阴道分娩盆底功能障碍患者57例作为观察组,选择同期50例阴道分娩盆底功能正常产妇作为对照组。所有产妇均接受SWE联合盆底超声检查。比较两组产妇一般资料及不同状态下杨氏模量值及其差值,并采用受试者工作特征曲线分析SWE联合盆底超声检查对阴道分娩盆底功能障碍的诊断价值。结果观察组产妇的产次、膀胱颈移动度、子宫颈外口移动度、直肠壶腹部移动度、尿道旋转度、盆膈裂孔面积高于对照组,而新生儿体重低于对照组,差异均有显著性(P<0.05)。观察组产妇静息状态、最大缩肛状态杨氏模量值和弹性值差值均高于对照组,差异有显著性(P<0.05)。受试者工作特征曲线分析结果显示,膀胱颈移动度、盆膈裂孔面积、新生儿体重、宫颈外口移动度、尿道旋转度、直肠壶腹部移动度单独及联合在诊断阴道分娩产妇产后盆底功能障碍中的曲线下面积均大于0.7,且上述指标联合诊断的曲线下面积最大。结论超声SWE联合盆底超声检查可准确评估阴道分娩产妇盆底功能障碍情况,具有较高的诊断价值,为临床早期防治盆底功能障碍提供参考。

Objective To explore the diagnostic efficacy of ultrasonic shear wave elastography(SWE)combined with pelvic floor ultrasound in pelvic floor dysfunction of parturients with vaginal delivery.Method 57 patients with pelvic floor dysfunction of vaginal delivery women admitted from September 2020 to December 2021 in our hospital were selected as the observation group,and 50 women with normal pelvic floor function were selected as the control group.All parturients underwent SWE and pelvic floor ultrasound.To compare the general data of the two groups of parturients and the value of Young’s modulus and its difference in different states,and to analyze the evaluation value of SWE combined with pelvic floor ultrasound on pelvic floor dysfunction after vaginal delivery.Result In the observation group,the number of labor,the bladder neck distance(BND),the cervical outer distance(COD),the rectal ampulla distance(RAD),the urethral rotation angle(URA)and the levator hiatus area(LHA)were higher than those in the control group,but the body mass of the newborn was lower than that in the control group(P<0.05);the differences of Young’s modulus and elastic value in the observation group were higher than those in the control group(P<0.05).The results showed that BND,LHA,neonatal body mass,COD,URA and RAD were all more than 0.7 in the evaluation of pelvic floor dysfunction after vaginal delivery,and the effect of combined evaluation was the best.Conclusion Ultrasonic SWE combined with pelvic floor ultrasound can accurately evaluate pelvic floor dysfunction of parturients with vaginal delivery,which has high diagnostic value and provides guidance for early prevention and treatment of pelvic floor dysfunction。