会阴三维超声观察阴道分娩及剖宫产产后女性的盆膈裂孔的变化及盆底功能损伤情况分析

摘要：目的　通过会阴三维超声观察阴道分娩及剖宫产产后女性的盆膈裂孔的变化及盆底功能损伤情况。 方法 入选2014年2月～2016年2月我院产科分娩后的产妇320例，按照不同分娩方式分为阴道分娩组(120例)与剖宫产组(200例)，另选取60例同时期我院妇科门诊以阴道炎就诊的未育且无分娩史妇女作为对照组。入选产妇于产后7天及产后2个月时接受两次会阴三维超声检查，对照组于门诊入组时接受会阴三维超声检查。并对测量结果进行统计学分析。结果 产后7天，静息状态和张力状态下，阴道分娩组、剖宫产组盆膈裂孔各项参数均大于对照组，差异有统计学意义(P<0.05)，其中阴道分娩组盆膈裂孔各项参数也显著高于剖宫产组，差异有统计学意义(PO.05)。剖宫产组，静息状态和张力状态下，产后7天和产后2个月盆膈裂各项参数比较差异均无统计学意义(P>O.05)。结论 经会阴超声评估不同分娩方式显示，阴道分娩和剖宫产对盆底组织功能均有影响，其中阴道分娩产后7天影响大于剖宫产，产后2个月，阴道分娩组盆底功能修复能力高于剖宫产组。

Changes of pelvic diaphragm and pelvic floor dysfunction in women with vaginal delivery and cesarean section by three dimensional ultrasound

Abstract: Objective To observe the changes of the pelvic diaphragm and the pelvic floor function injury of the female pelvic floor by three dimensional ultrasound in the vaginal delivery and cesarean section. Methods 320 cases of maternal February 2014 to 2016 February hospital obstetric delivery after selected, according to the different modes of delivery points for vaginal delivery group (120 cases) with caesarean birth group (200 cases), the other to select 60 cases of the same period in our hospital out-patient gynecological vaginitis treatment of no education and no women in labor history as the control group. After 7 days and 2 months postpartum, the women received the two perineal three dimensional ultrasound examination, while the control group received three-dimensional ultrasound examination. And the measurement results were statistically analyzed. Results 7 days postpartum, resting state and tension, vaginal delivery and cesarean section production group of pelvic diaphragm hole parameters of the crack were higher than control group, the difference was statistically significant (P < 0.05), and the vaginal delivery group of pelvic diaphragm crack hole parameters was also significantly higher than that in the cesarean section group, the difference has statistical significance (P < 0.05). 2 months postpartum, resting state and tension state, vaginal delivery group, cesarean section of the parameters of the diaphragm is greater than the control group, the difference was statistically significant (P<0.05). Vaginal delivery group, resting state and tension state, postpartum 7 days and 2 months postpartum pelvic diaphragm area difference was statistically significant (PO.05). There was no significant difference in the parameters of the 7 days of postpartum days and 2 months after delivery in the cesarean section, resting state and tension state. Conclusion transperineal sonography in the evaluation of different modes of delivery, vaginal delivery and cesarean section birth of pelvic organ function were affected, of which 7 days postpartum to influence greater than splits the palace production. 2 months after delivery, vaginal delivery group function of pelvic floor repair capacity higher than cesarean section group.