摘要
目的应用盆底超声评估骨盆环疾病孕妇经阴道分娩后的盆底功能,探讨其临床应用价值。方法选取在我院定期产检并行经阴道分娩的初次产妇150例(妊娠期间患骨盆环疾病)为病例组,以及无骨盆环疾病者150例为对照组。两组均于经阴道分娩后42 d使用二维、三维、四维盆底超声分别评估其盆底功能,比较Valsalva状态下膀胱颈距耻骨联合下缘的距离(BSD)、膀胱颈下降距离(BND)、膀胱尿道后角(PUA),以及静息状态和Valsalva状态下盆膈裂孔前后径(LHAP)、肛提肌裂孔左右径(LHLR)、肛提肌裂孔最大面积、肛提肌厚度的差异,分析两组孕妇产后盆底功能障碍性疾病发生情况。结果二维盆底超声检查显示,病例组Valsalva状态下BND低于对照组,BSD及PUA均高于对照组,差异均有统计学意义(均P<0.05);三维盆底超声检查显示,病例组静息状态和Valsalva状态下LHLR、LHAP均高于对照组,差异均有统计学意义(均P<0.05);四维盆底超声检查显示,病例组静息状态和Valsalva状态下肛提肌裂孔最大面积均高于对照组,肛提肌厚度均低于对照组,差异均有统计学意义(均P<0.05)。病例组产后子宫脱垂、阴道前壁膨出、阴道后壁膨出、压力性尿失禁的发生率等均高于对照组,差异均有统计学意义(均P<0.05)。结论盆底超声可准确评估骨盆环疾病孕妇经阴道分娩后盆底功能变化,具有较好的临床应用价值。
Objective To evaluate pelvic floor function in pregnant women with pelvic ring disease after vaginal delivery by pelvic floor ultrasound,and to explore its clinical application value.Methods A total of 150 primiparas with pelvic ring disease during pregnancy underwent regular prenatal examinations and vaginal delivery in our hospital(case group)were enrolled,and 150 cases without the pelvic ring disease selected as control group.The pelvic floor function was assessed at 42 d after vaginal delivery by two-dimensional,three-dimensional and four-dimensional pelvic floor ultrasound.The bladder necksymphyseal distance(BSD),bladder neck-symphyseal descent(BND),posterior urethrovesical angle(PUA)under Valsalva state,and levator hiatal anteroposterinr diameter(LHAP),levator hiatal lateral diameter(LHLR),the maximum area of levator,the thickness of levator ani under rest and Valsalva states were compared.The occurrence of postpartum pelvic floor dysfunction in two groups were analyzed.Results Two-dimensional pelvic floor ultrasound showed that BND under Valsalva state in the case group was lower than that in the control group,while BSD and PUA were higher than those in the control group(all P<0.05).Three-dimensional pelvic floor ultrasound showed that LHLR and LHAP under rest and Valsalva states in the case group were higher than those in the control group(both P<0.05).Four-dimensional pelvic floor ultrasound showed that the maximum area of levator hiatus under rest and Valsalva states in the case group was larger than that in the control group,and the thickness of levator ani was thinner than that in the control group(both P<0.05).The incidence of uterine prolapse,encephalocele of anterior vaginal wall,encephalocele of posterior vaginal wall and stress incontinence in case group were higher than those in the control group(all P<0.05).Conclusion Pelvic floor ultrasound can accurately evaluate the changes of pelvic floor function in pregnant women with pelvic ring disease after vaginal delivery,which has good clinical application value.
作者
舒红艳
李玮健
SHU Hongyan;LI Weijian(Department of Ultrasound Medicine,Huangshi Maternal and Child Health Hospital,Hubei 435000,China)
出处
《临床超声医学杂志》
CSCD
2024年第3期254-257,共4页
Journal of Clinical Ultrasound in Medicine
基金
黄石市妇幼保健院2022-2023年度院级科研课题(HSMCHH2022008)。
关键词
盆底超声
二维
三维
四维
骨盆环疾病
经阴道分娩
盆底功能障碍
Pelvic floor ultrasound,two-dimensional,three-dimensional,four-dimensional
Pelvic ring disease
Vaginal delivery
Pelvic floor dysfunction
