首页|盆底超声联合盆底肌力检测对产后盆底功能评估和盆底功能障碍性疾病预测的应用价值

盆底超声联合盆底肌力检测对产后盆底功能评估和盆底功能障碍性疾病预测的应用价值

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目的 分析盆底超声联合盆底肌力检测对评估产后盆底功能和预测产后3年发生盆底功能障碍性疾病的应用价值.方法 收集2019年9月至2020年12月间于中国医科大学附属盛京医院联合行盆底超声和盆底肌力检测的192例产后42d产妇的临床资料,其中阴道分娩组 85例,剖宫产组107例.比较2组盆底肌力检测和盆底超声相关指标的水平和异常率.随访至2023年12月,统计产后3年内盆腔器官脱垂和压力性尿失禁的发生情况.结果 盆底超声结果异常102例(53.13%);盆底肌力检测中,I类肌纤维疲劳度的异常率最高,为85.94%.与剖宫产组相比,阴道分娩组膀胱颈移动度、膀胱后角开放、膀胱膨出、肛提肌损伤、肛提肌裂孔面积、会阴体活动度、阴道动态压力等指标的异常率更高(P<0.05).阴道分娩组与剖宫产组相比,膀胱颈移动度、肛提肌裂孔面积、Valsalva动作时膀胱颈至耻骨联合下缘距离以及直肠壶腹至耻骨联合下缘距离、阴道动态压力、肌力等级等指标水平的差异有统计学意义(P<0.05).随访3年,阴道分娩组和剖宫产组分别有22例和8例发生盆腔器官脱垂,分别有13例和6例发生压力性尿失禁,阴道分娩组盆腔器官脱垂和压力性尿失禁的发生率均明显高于剖宫产组(P<0.05).2组中发生盆腔器官脱垂和压力性尿失禁的患者,其产后42d盆底超声检查结果和盆底肌力检测结果均异常.结论 50%以上的单胎初产妇产后存在盆底功能和结构异常.产后42d盆底超声和盆底肌力检测结果均异常者,日后发生盆底功能障碍性疾病的概率更大.
Application of pelvic floor ultrasound combined with pelvic floor muscle strength detection in evaluating postpartum pelvic floor function and predicting pelvic floor dysfunction
Objective To analyze the application of pelvic floor ultrasound combined with pelvic floor muscle strength detection in the evaluation of postpartum pelvic floor function and prediction of pelvic floor dysfunction three years after delivery.Methods A total of 192 women at 42 days postpartum were enrolled,including 85 in the vaginal delivery group and 107 in the cesarean section group.The abnormal rates and levels of the indicators related to pelvic floor muscle strength detection and pelvic floor ultrasound were compared.The patients were followed up for three years,and the incidence of pelvic organ prolapse and stress urinary incontinence were analyzed.Results The results of pelvic floor ultrasound were abnormal in 102 patients(53.13%).The abnormal rate of fatigue of typeⅠmuscle fibers was highest(85.94%)in pelvic floor muscle strength detection.The abnormal rates of bladder neck mobility,bladder posterior angle opening,cystocele,levator ani muscle injury,levator hiatus area,perineal body activity,and vaginal dynamic pressure were significantly higher in the vaginal delivery group than those of the cesarean section group(P<0.05).There were significant between-group differences in the mean values of bladder neck movement,levator hiatus area,distances from the bladder neck to the lower margin of the pubic symphysis and from the ampulla of the rectum to the lower margin of the pubic symphysis during the Valsalva movement,vaginal dynamic pressure,and muscle strength(P<0.05).After the 3-year follow-up,the incidences of pelvic organ prolapse and stress urinary inconti-nence were significantly higher in the vaginal delivery group than in the cesarean section group(P<0.05).In the patients with pelvic floor dysfunction,the results of pelvic floor ultrasound and pelvic floor muscle strength detection were both abnormal at 42 days postpartum.Conclusion The patients with abnormal results of pelvic floor ultrasound and pelvic floor muscle strength detection at 42 days post-partum are more likely to have pelvic floor dysfunction in the future.

pelvic floor ultrasoundpelvic floor muscle strength detectionpostpartumpelvic floor dysfunction

秦美英、夏志军

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中国医科大学附属盛京医院妇产科,沈阳 110004

盆底超声 盆底肌力检测 产后 盆底功能障碍性疾病

国家重点研发计划国家自然科学基金

2021YFC270130282271613

2024

中国医科大学学报
中国医科大学

中国医科大学学报

CSTPCD北大核心
影响因子:1.421
ISSN:0258-4646
年,卷(期):2024.53(8)