【摘要】：目的探討應(yīng)用經(jīng)會陰三維超聲評價選擇性剖宮產(chǎn)后產(chǎn)婦的盆底功能變化。方法選取行選擇性剖宮產(chǎn)分娩的初產(chǎn)婦86例作為研究對象,于產(chǎn)后42 d行經(jīng)會陰三維超聲檢查,觀察靜息狀態(tài)及Valsalva動作時有無盆底組織異常,測量并計算膀胱頸移動度、肛提肌裂孔面積等指標(biāo)。根據(jù)超聲檢查結(jié)果,將病例分為有盆底功能障礙組(觀察組)以及無盆底功能障礙組(對照組)兩組,對兩組產(chǎn)婦的臨床檢查及超聲檢查結(jié)果進(jìn)行統(tǒng)計學(xué)分析。結(jié)果 86例選擇性剖宮產(chǎn)后產(chǎn)婦中有盆底功能障礙者(觀察組)18例,無盆底功能障礙者(對照組)68例。觀察組初產(chǎn)婦臨床檢查壓力性尿失禁6例,陰道前壁脫垂1例,子宮脫垂1例,其余10例未檢出異常。對照組初產(chǎn)婦臨床檢查壓力性尿失禁9例,其余59例未檢出異常。觀察組初產(chǎn)婦經(jīng)會陰三維超聲檢查膀胱頸活動度增加13例,陰道前壁脫垂2例,子宮脫垂2例,直腸膨出1例。對照組初產(chǎn)婦經(jīng)會陰三維超聲未檢出異常。觀察組初產(chǎn)婦在Valsalva動作時,膀胱頸移動度明顯大于對照組(P0.05),肛提肌裂孔的面積明顯大于對照組(P0.05),差異有統(tǒng)計學(xué)意義。結(jié)論經(jīng)會陰三維超聲檢查可以早期發(fā)現(xiàn)輕度的盆底功能障礙,可以簡便有效地評價選擇性剖宮產(chǎn)后的盆底功能變化。
[Abstract]:Objective to evaluate the pelvic floor function after selective cesarean section by transperineal three-dimensional ultrasound. Methods Eighty-six primipara who were delivered by selective cesarean section were examined by transperineal three-dimensional ultrasonography at 42 days postpartum. The pelvic floor tissue was observed in resting state and Valsalva, and the bladder neck movement was measured and calculated. Area of fissure of levator ani muscle, etc. According to the results of ultrasonic examination, the patients were divided into two groups: the group with pelvic floor dysfunction (observation group) and the group without pelvic floor dysfunction (control group). Results there were 18 cases of pelvic floor dysfunction (observation group) and 68 cases of no pelvic floor dysfunction (control group) in 86 cases of elective cesarean section. In the observation group, 6 cases of stress urinary incontinence, 1 case of vaginal anterior wall prolapse, 1 case of uterine prolapse, and 10 cases of other 10 cases were not detected abnormal. In the control group, 9 cases of stress urinary incontinence were clinically examined, while 59 cases were not abnormal. In the observation group, 13 cases of bladder neck increased, 2 cases of vaginal anterior wall prolapse, 2 cases of uterine prolapse and 1 case of rectocele by transperineal three-dimensional ultrasound. In the control group, no abnormality was detected by perineal three-dimensional ultrasound. The movement degree of bladder neck was significantly larger than that of the control group (P0.05), and the area of the sphincter fissure was significantly larger than that of the control group (P0.05) during the Valsalva movement in the observation group, and the difference was statistically significant. Conclusion Transperineal three-dimensional ultrasonography can detect mild pelvic floor dysfunction in early stage and can be used to evaluate the pelvic floor function after selective cesarean section.
【作者單位】： 廣州醫(yī)科大學(xué)附屬第三醫(yī)院超聲醫(yī)學(xué)科;
【分類號】：R445.1;R719.8

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