经会阴四维盆底超声立体成像检测初产妇盆底肌及盆膈裂孔异常

发布时间：2018-01-05 19:25

本文关键词：经会阴四维盆底超声立体成像检测初产妇盆底肌及盆膈裂孔异常　出处：《中国医学装备》2017年03期 　论文类型：期刊论文

【摘要】：目的:应用经会阴四维盆底超声立体成像检测盆膈裂孔及肛提肌损伤,进行盆底肌力异常分级,比较其在初产妇盆底功能障碍(PFD)阴道分娩和选择性剖宫产盆膈裂孔及肛提肌损伤的程度,为临床治疗提供依据。方法:采用数表法随机将270例患有PFD疾病的初产妇分为经阴道分娩组和选择性剖宫产组,每组135例,应用经会阴四维盆底超声立体成像,分别检测两组盆底肌力和盆膈裂孔前后径、横径、面积及肛提肌厚度,并进行组间比较。结果:两组患者中盆底肌力异常162例(占60%),阴道压力异常189例(占70%)。盆底肌疲劳度:Ⅰ类肌纤维肌力异常127例(占47%),Ⅱ类肌纤维肌力异常30例(占11%)。比较阴道分娩组和选择性剖宫产组的盆底肌力、阴道压力及肌纤维肌力的异常率均无差异。经阴道分娩组的盆膈裂孔前后径、横径及面积均高于选择性剖宫产组,肛提肌厚度小于选择性剖宫产组,两组比较差异具有统计学意义(t=3.730,t=3.467,t=3.826,t=1.809;P0.05)。结论:研究结果表明,经阴道分娩组的盆膈裂孔前后径、横径及面积均高于选择性剖宫产组,肛提肌厚度小于选择性剖宫产组。四维超声立体成像可直观显示出女性盆膈裂孔的形态学特征,为产后PFD的临床诊断和治疗评估提供依据。
[Abstract]:Objective: the application of transperineal ultrasound three-dimensional imaging detection of four-dimensional pelvic hiatus and levator ani muscle injury, pelvic floor muscle abnormalities in the classification, early maternal pelvic floor dysfunction (PFD) of vaginal delivery and selective caesarean section of pelvic diaphragm hiatus and levator ani muscle injury, to provide the basis for clinical treatment. Using random number table method: the 270 cases of primipara with PFD disease were divided into vaginal delivery group and selective cesarean section group, 135 cases in each group, using transperineal pelvic ultrasound four-dimensional three-dimensional imaging, we detected two groups of pelvic floor muscle strength and hiatus anteroposterior diameter, transverse diameter, area and thickness of the levator ani muscle. And compared between groups. Results: two patients with pelvic muscle abnormalities in 162 cases (60%), 189 cases of abnormal vaginal pressure (70%). Pelvic floor muscle fatigue: type I muscle muscle abnormalities in 127 cases (47%), type II muscle fiber muscle abnormalities in 30 cases (11%). The vagina Delivery group and selective cesarean section group of pelvic floor muscle strength were no difference in the abnormal rate of vaginal pressure and muscle fiber strength. The pelvic diaphragm hiatus before and after vaginal delivery group the diameter, transverse diameter and area were higher than that of selective cesarean section group, levator ani muscle thickness is less than the selective cesarean section group, two groups were compared the difference was statistically significant (t=3.730, t=3.467, t=3.826, t=1.809; P0.05). Conclusion: the results showed that the pelvic diaphragm hiatus before and after vaginal delivery group the diameter, transverse diameter and area were higher than that of selective cesarean section group, levator ani muscle thickness is less than the selective cesarean section group. Four dimensional ultrasound three-dimensional imaging can be visually displayed the morphological characteristics of female pelvic diaphragm hiatus, provide the basis for clinical diagnosis and treatment of postpartum PFD evaluation.

【作者单位】：玉林市妇幼保健院超声科;
【基金】：玉林市科学研究与技术开发计划(1535031)“四维盆底超声在初产妇盆底功能障碍性疾病中的应用研究”
【分类号】：R445.1;R714
【正文快照】： 女性盆底功能障碍(pelvic floor dysfunction,PFD)疾病是因盆底结构形态及功能异常而引起,主要表现在盆腔器官脱垂(pelvic organ prolapse,POP)、大小便失禁及膀胱过度活动症等疾病所引起的临床症状[1]。女性盆底的结构比较复杂,主要包括特殊平滑肌、相连韧带和筋膜以及自主神

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