盆底超声及盆底肌力评估分析分娩对女性肛门括约肌复合体的影响*

目的：探讨盆底超声及盆底肌力评估分析分娩对女性肛门括约肌复合体（ASC）的影响。方法：选取2018 年1 月～ 2019 年1 月于本院妇科门诊进行产后复查的患者，包括阴道分娩产妇（ 阴道分娩组）和剖宫产产妇（ 剖 宫产组），2 组均进行妇科检查、盆底超声及盆底肌力评估，比较2 组肛门内括约肌（ IAS）近端平面、中部平面、 远端平面及肛门外括约肌（ EAS）远端平面3、6、9、12 点钟方向的厚度，耻骨直肠肌（ PRM）中部平面4、8 点钟方向的厚度，盆底肌力评估指标。结果：与剖宫产组IAS 近端6 点、12 点，IAS 中部12 点厚度测量值比较， 阴道分娩组显著降低；与剖宫产组EAS远端12 点厚度测量值比较，阴道分娩组显著降低；与剖宫产组Ⅱ类肌最 大收缩力和Ⅰ类肌持续收缩力比较，阴道分娩组显著降低，差异具有统计学意义。结论：盆底超声能够对顺产及 剖宫产产妇的ASC进行有效评估，与剖宫产产妇比较，顺产产妇产后IAS、EAS均发生较大改变，且顺产产妇产 后盆底Ⅱ类肌最大收缩力及Ⅰ类肌持续收缩力均降低。

Analysis of the effect of delivery on anal sphincter complex in women by pelvic floor ultrasound and pelvic floor muscle strength evaluation*

Objective To study the effect of pelvic floor ultrasound and pelvic floor muscle strength on evaluation of the anal sphincter complex （ ASC） in women. Methods From January 2018 to January 2019， 100 patients who underwent postpartum reexamination in gynecological clinic of our hospital were selected and classified into vaginal delivery group （56 cases） and Caesarean section group （44 cases）. Gynecological examination， pelvic floor ultrasound and pelvic floor muscle strength evaluation were performed in both groups. The thickness of proximal plane， middle plane， distal plane of internal anal sphincter （ IAS）and the 3， 6， 9， 12 o'clock of distal plane of external anal sphincter （ EAS）， the thickness of middle plane of pubic rectum muscle （ PRM） at 4， 8 o'clock， and the evaluation index of pelvic floor muscle strength were compared between two groups. Results The thickness measurement values of IAS proximal 6-point，12-point， IAS central 12-point in Caesarean section group were significantly higher than that in vaginal delivery group. The thickness of EAS remote 12-point in Caesarean section group was significantly higher than that in vaginal delivery group. The maximum contractility and continuous contractility of class Ⅱ muscles in Caesarean section group were significantly higher than those in vaginal delivery group. Conclusion Pelvic floor ultrasound can effectively evaluate the ASC of parturients with parturient delivery and Caesarean section. Compared with parturients with Caesarean section， the postpartum IAS and EAS of parturients with parturient delivery change greatly， and the maximum contractility of class Ⅱ muscles and the continuous contractility of type I muscles decrease in parturients with parturient delivery.