| 初次产后早期盆底形态的三维超声研究 |
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| 引用本文： | 张美琴,罗 红. 初次产后早期盆底形态的三维超声研究[J]. 四川大学学报(医学版), 2016, 47(2): 253-256 |
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| 作者姓名： | 张美琴 罗 红 |
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| 作者单位： | 1.四川大学华西第二医院 超声科 |
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| 摘 要： | 目的 应用经会阴三维超声研究不同分娩方式产后女性盆膈裂孔形态变化以及下尿路膀胱颈移动度，以评估产后早期女性盆底恢复情况。 方法 对170例初产妇（分为经阴道分娩及剖宫产）及35例已婚未育女性进行盆底超声检查，获得静息、Valsalva及缩肛时人体盆底正中矢状切面及盆底轴切面重建图像，测量一系列生物参数。结果 产后6~8周在缩肛状态下经阴道分娩组盆膈裂孔纵径测值大于未育组（ P<0.05)；而剖宫产组盆膈裂孔参数与未育组间比较差异无统计学意义（ P>0.05)。膀胱颈移动度在Valsalva时表现为经阴道分娩者大于剖宫产组及未育组（ P<0.05)，而剖宫产组仅背侧运动大于未育组（ P<0.05)。产后6~8周剖宫产组压力性尿失禁发生率4.5%（3/66），经阴道分娩组压力性尿失禁发生率9.6%（10/104），而两者间差异无统计学意义（ P>0.05)。 结论 经阴道分娩后产妇盆底组织结构改变较剖宫产者明显。膀胱颈移动度及盆膈裂孔纵径是评估盆底肌收缩能力的重要指标，且后者更敏感，可以作为观察产后盆底肌恢复与否的观察指标。
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| 关 键 词： | 三维超声 盆底 经阴道分娩 剖宫产 |
Three-dimensional Ultrasound of the Pelvic Floor in Early Postpartum after First Delivery |
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| ZHANG Mei-qin,LUO HongY。. Three-dimensional Ultrasound of the Pelvic Floor in Early Postpartum after First Delivery[J]. Journal of Sichuan University. Medical science edition, 2016, 47(2): 253-256 |
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| Authors: | ZHANG Mei-qin LUO HongY。 |
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| Abstract: | Objective To dynamically observe the shape of levator hiatus and the mobility of bladder neck with three dimensional transperineal ultrasound, and then to evaluate female pelvic floor in early postpartum after delivery. Methods 170 primiparae (the vaginal delivery group and the cesarean section group) and 35 nulliparous women were recruited, and three dimensional transperineal ultrasound were performed with standardized gynecological pelvic settings. Ultrasonic dynamic imaging information was obtained in the condition of resting, Valsalva maneuver and anal sphincter contraction, including two-dimensional midsagittal view and the three-dimensional axial plane in which some biometric measurements were determined. Results The anteroposterior diameters of levator hiatus were significantly greater on sphincter contraction in the vaginal delivery group than that in nulliparous group after the 6-8 weeks delivery, but the measurements of the levator hiatus within cesarean delivery group and nulliparous group did not show statistically significant differences ( P>0.05). The mobility of bladder neck was significantly greater on Valsalva maneuver in the vaginal delivery group than those in the other groups, while the backward motion of bladder neck was greater on Valsalva maneuver in the cesarean section group than that in nulliparous group. The incidence of postpartum stress urinary incontinence was greater in the vaginal delivery group (10/104) than that in the cesarean section group (4.5%,3/66), but no statistically significant differences were observed ( P>0.05). Conclusion The large difference of pelvic floor exists between vaginal delivery and cesarean delivery. The bladder neck decent and levator hiatus anteroposterior diameter may be relatively sensitive indicators in ultrasonic evaluation of pelvic floor muscle contraction, especially the latter may be adopted as an observation index to evaluate pelvic floor muscle recovery after delivery. |
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| Keywords: | Three dimensional transperineal ultrasound Pelvic floor Vaginal delivery Cesarean section |
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