四维彩超对产道裂伤产妇盆底功能诊断和随访价值的研究

Value Study of Diagnostic and Follow up Value of Four Dimensional Ultrasound for Pelvic Floor Function of Pregnant Women with Maternal Tract Lacerations

目的探讨四维彩超对产道裂伤产妇盆底功能诊断和随访价值。方法选取2021年4月—2023年4月本院诊断为产道裂伤产妇60例为研究组,匹配60例剖宫产产妇为对照组,产后42d与3个月两组产妇均进行四维彩超检查,对两组彩超检查诊断结果进行分析。结果产后42d,相较于对照组,研究组患者动态情况下肛提肌裂孔前后径更长(P<0.05);研究组尿道膀胱后角、BND、最大面积更大(P<0.05);研究组膀胱颈旋转角度、尿道旋转角更大(P<0.05);研究组Ⅰ型、Ⅲ型占比更低(P<0.05),研究组Ⅱ型占比更高(P<0.05);研究组肛提肌撕裂、压力性尿失禁、直肠前壁膨出、阴道前壁脱垂检出率更高(P<0.05)。产后3个月,动作状态下,研究组肛提肌裂孔前后径更长(P<0.05);研究组尿道膀胱后角、BND、最小面积更大(P<0.05);研究组尿道旋转角更大(P<0.05);但是与产后42d相比,有所改善。结论四维彩超对产道裂伤产妇实施盆底功能诊断,其临床价值较为显著,可以使治疗医师直观了解到产妇的盆腔结构,掌握分娩后的产妇盆底肌群功能,为临床诊断产妇产后盆底功能障碍提供有利的参考数据,临床应用价值高。

Objective To explore diagnostic and follow-up value of four-dimensional ultrasound for pelvic floor function of postpartum women with birth canal lacerations.Methods The paper chose 60 pregnant women with birth canal lacerations in our hospital from April 2021 to April 2023 as study group,and 60 pregnant women with cesarean section as control group.Two groups were treated with four dimensional ultrasound examinations at 42 days and 3 months postpartum.Results Study group had longer anterior posterior diameter of levator ani muscle hiatus under dynamic conditions(P<0.05),larger posterior angle,BND,and maximum area of urethra bladder(P<0.05),and larger bladder neck rotation angle and urethral rotation angle than control group(P<0.05),with lower proportion of Type I and TypeⅢin study group(P<0.05),while proportion of typeⅡin study group was higher(P<0.05).Detection rate of levator ani muscle tear,stress urinary incontinence,anterior rectal wall prolapse,and anterior vaginal wall prolapse was higher in study group(P<0.05).At the action state,anterior posterior diameter of the levator ani muscle hiatus was longer in study group(P<0.05),the posterior angle of urethra and bladder,BND,and minimum area was larger in study group(P<0.05),and urethral rotation angle was larger in study group(P<0.05).However,compared with 42 days postpartum,there was an improvement.Conclusion 4D ultrasound can achieve significant clinical value in diagnosing pelvic floor function of postpartum women with birth canal lacerations.Physicians can understand pelvic structure of puerpera,master pelvic floor muscle group function after delivery,and provide favorable reference data for clinical diagnosis of postpartum pelvic floor dysfunction,which has high clinical application value.