经会阴三维超声检查初产妇肛提肌损伤及其危险因素相关性研究

发布时间：2018-01-01 23:00

本文关键词：经会阴三维超声检查初产妇肛提肌损伤及其危险因素相关性研究　出处：《重庆医学》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨经会阴三维超声评估初产妇肛提肌损伤的危险因素。方法选取2013年2月至2014年6月在新疆医科大学第五附属医院就诊的81例初产妇进行观察研究。使用经会阴三维超声观察81例经阴道分娩的初产妇产后6~8周的肛提肌,对所有可能导致初产妇肛提肌损伤的危险因素进行回顾性分析,其中包括受试者的新生儿头围(HC)、出生体质量、第二产程时长、母体年龄、婴儿性别、会阴侧切及器械分娩。对以上所有的可能因素进行研究,应用Logistic多元回归的统计学方法分析产后肛提肌损伤发生的独立危险因素。结果通过经会阴三维超声观察81例初产妇的肛提肌,其中13例(16.05%)初产妇肛提肌损伤。单因素分析影响肛提肌损伤的因素有:较大的胎儿头围,较长的第二产程时长,较大体质量,会阴侧切,器械分娩。多因素Logistic回归分析结果显示:胎儿头围OR=5.72(95%CI:1.68~19.47),第二产程时长OR=4.93(95%CI:1.65~14.68),胎儿体质量OR=1.90(95%CI:1.09~3.29),器械分娩OR=1.36(95%CI:1.05~2.51),会阴侧切OR=1.41(95%CI:1.16~5.47),以上均为独立危险因素。结论胎儿性别、母体年龄不是初产妇肛提肌损伤的独立危险因素,较大的头围和较长的第二产程是初产妇肛提肌损伤的主要危险因素。
[Abstract]:Objective to investigate the risk factors for evaluating the injury of levator ani muscle by transperineal three dimensional ultrasound. Methods 81 primiparas who were admitted to the 5th affiliated Hospital of Xinjiang Medical University from February 2013 to June 2014 were selected. Observation and study. The levator ani muscle of 81 cases of primipara who were delivered by vagina was observed by transperineal three-dimensional ultrasound at 6 and 8 weeks postpartum. A retrospective analysis of all the risk factors that may lead to the injury of levator ani muscle in primipara was carried out, including the head circumference of the newborn, the birth weight, the duration of the second labor, the age of the mother, and the sex of the infant. Perineal resection and instrumentation delivery. All the possible factors mentioned above were studied. Logistic multivariate regression was used to analyze the independent risk factors of postpartum levator ani muscle injury. Results 81 primipara patients were observed by transperineal three-dimensional ultrasound. Single factor analysis of the factors influencing the injury of levator ani muscle were: larger fetal head circumference, longer second labor process, larger body mass, lateral perineal resection. Instrument delivery. The results of multivariate Logistic regression analysis showed that the fetal head circumference was 5.72 ~ 95 CI: 1.68 ~ 19.47). The length of the second labor was 4.93 / 95 CI: 1.65 / 14.68, and the weight of the fetus was 1.90 / 95 / CI: 1.09 / 3.29). Instrument delivery OR1.36595 CI1: 1.05U 2.51%, perineal side resection of OR1. 41% 95 CI 1. 16 / 5.47). Conclusion Fetal sex and maternal age are not independent risk factors for the injury of levator ani muscle in primipara. Larger head circumference and longer second stage of labor are the main risk factors for injury of levator ani muscle in primipara.
【作者单位】：上海长海医院超声科;新疆医科大学第五附属医院超声科;
【基金】：新疆维吾尔自治区自然科学基金资助项目(2012211A049)
【分类号】：R445.1;R714.6
【正文快照】： 盆底功能障碍性疾病,如盆腔器官脱垂、压力性尿失禁等与肛提肌功能状态密切相关[1]。肛提肌为一组盆底肌群,呈U型吊带,是支持盆底的最重要的结构,支持盆底裂孔、尿道、阴道和直肠。其最重要的部分是耻骨内脏肌,即耻骨直肠肌与耻骨尾骨肌的复合体。三维盆底超声是近年来的一门

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