摘要
目的 探讨经阴道分娩后骨盆环疾病孕产妇应用超声检查评估其盆底功能的临床价值.方法 选取骨盆环疾病经阴道分娩孕产妇 80 例为观察组,选取同期孕产妇 60 例为对照组.应用超声扫描盆底结构,分别在静息状态和屏气用力呼吸、咳嗽等(Valsalva)动作,检测耻骨联合下缘的距离(BSD)、膀胱尿道后角(PUA)、膀胱颈移动距离(BND)、盆膈裂孔前后径(LHAP)、肛提肌裂孔左右径(LHLR),肛提肌裂孔最大面积和肛提肌厚度.结果 静息状态时,观察组PUA、BND、LHAP、LHLR、肛提肌厚度及肛提肌裂孔最大面积结果为(124.70±11.46)°、(28.48±2.90)mm、(3.25±0.32)cm、(5.13±0.57)cm、(6.42±0.58)mm、(20.44±2.86)cm2,高于对照组的各项数值(116.92±12.05)°、(24.62±2.97)mm、(2.60±0.29)cm、(4.70±0.61)cm、(8.13±0.64)mm、(18.26±2.70)cm2,差异有统计学意义(P<0.05).Valsalva动作后观察组PUA、BND、LHAP、LHLR、肛提肌厚度及肛提肌裂孔最大面积结果为(139.98±15.23)°、(31.48±3.17)mm、(3.76±0.41)cm、(5.90±0.65)cm、(7.52±0.96)mm、(22.87±3.16)cm2,高于对照组的各项数值(131.82±14.17)°、(26.14±2.85)mm、(3.11±0.37)cm、(4.65±0.73)cm、(9.60±0.91)mm、(19.79±2.94)cm2,差异有统计学意义(P<0.05),静息状态和Valsalva动作后,观察组BSD为(16.21±2.30)mm和(17.25±2.23)mm,低于对照组(18.59±2.27)mm和(19.04±2.31)mm,差异有统计学意义(P<0.05).结论 经阴道分娩后骨盆环疾病孕产妇应用超声进行扫描,能全面立体观察盆底功能的变化.
Abstract
Objective The pelvic floor function of the pregnant women with pelvic ring disease after vaginal delivery was evaluated by ultrasonography to guide the rehabilitation of the pregnant women with pelvic ring disease.Methods 80 parturi-ents with pelvic ring disease who underwent vaginal delivery were selected as the observation Group,and 60 parturients without pelvic ring disease during the same period were selected as the control group.The pelvic floor structure was scanned by ultra-sound in resting state,and breath holding,forced breathing and coughing(Valsalva).We measured the distance of inferior bor-der of pubic symphysis(BSD),posterior angle of bladder urethra(PUA),distance of bladder neck movement(BND),anterior and posterior diameter of pelvic diaphragmatic hiatus(LHAP),left and right diameter of levator ani(LHLR),maximum area of levator ani hiatus,and thickness of levator animuscle.Results The PUA,BND,LHAP,LHLR,the thickness of the levator ani muscle and the maximum area of the levator ani hiatus were(139.98±15.23)°,(31.48±3.17)mm,(3.76±0.41)cm,(5.90±0.65)cm,(7.52±0.96)mm,and(22.87±3.16)cm2,which were higher than the values of the control group(131.82±14.17)°,(26.14±2.85)mm,(3.11±0.37)cm,(4.65±0.73)cm,(9.60±0.91)mm and(19.79±2.94)cm2(P<0.05).Af-ter resting state and Valsalva maneuver,the BSD of the observation group was(16.21±2.30)mm and(17.25±2.23)mm,which were lower than the control group's(18.59±2.27)mm and(19.04±2.31)mm(P<0.05).Conclusion Ultrasound scanning can comprehensively observe the changes of pelvic floor function and guide the rehabilitation of pregnant women with pelvic ring disease after vaginal delivery.
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