摘要
目的 通过超声定量分析评估二次分娩后不同分娩方式对盆底功能的影响.方法 收集2018年1月～2020年12月二次分娩后产后6周于我院产科复查盆底超声的女性,共922例.根据分娩方式将研究对象分为4组:两次阴道分娩组(A组,244例);剖宫产后阴道分娩组(B组,219例);阴道分娩后剖宫产组(C组,222例);两次剖宫产组(D组,237例).所有研究对象均进行盆腔脏器脱垂(pelvic organ proplapse,POP)分期并测量超声定量参数:残余尿、逼尿肌厚度、尿道倾斜角(urethral inclination,UI)、尿道旋转角(urethral angle of rotation,UAR)、膀胱移动度(bladder mobility,BM)、膀胱尿道后角(pos-terior vesicourethra angle,PVA)、膀胱位置、子宫位置、直肠位置、肛提肌裂孔(levator ani musculus hole,LAMH)面积.比较不同分娩方式的超声定量参数的差异.结果 4组不同分娩方式产后POP发病率不同,A组发病率最高(P＜0.05).4组比较盆底超声定量参数:UI、UAR、BM、PVA、膀胱位置、子宫位置、直肠位置、LAMH面积差异均存在统计学意义(P＜0.05).结论 分娩后POP发病率与不同分娩方式有关,通过盆底超声定量参数测量可对产后POP进行预测.
Abstract
Objective To analyze the effect of different modes of delivery on pelvic floor func-tion in second delivery by ultrasound quantitative analysis.Methods The clinical and ultra-sonic data of 922 women who underwent pelvic floor ultrasound in the Department of Obstetrics in our hospital 6 weeks postpartum after the second delivery from January 2018 to December 2020 were collected.According to different delivery mode,they were divided into four groups,including two natural birth group(group A,244 cases),cesarean delivery-natural birth group(group B,219 cases),natural birth-cesarean section group(group C,222 cases):two cesar-ean sections(group D,237 cases).All study subjects underwent pelvic organ proplapse(POP)staging and measurement of ultrasound quantitative parameters:residual urine,detrusor thickness,urethral inclination(UI),urethral angle of rotation(UAR),bladder mobility(BM),posterior vesicourethra angle(PVA),bladder position,uterine position,rectal position,and levator ani musculus hole(LAMH)area.The ultrasound quantitative parameters of different de-livery modes were compared.Results The incidence of postpartum POP was different in the four groups with different delivery methods,and the incidence rate was the highest in group A(P＜0.05).There were statistically significant differences in the quantitative parameters of pelvic floor ultrasound:UI,UAR,BM,PVA,bladder position,uterine position,rectal posi-tion,and LAMH area among the four groups(P＜0.05).Conclusion The incidence of post-partum POP is related to different modes of delivery,and the measurement of quantitative pa-rameters of pelvic floor ultrasound can predict postpartum POP.
维普
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