低位产钳助产术对女性盆底功能的影响

发布时间：2018-07-14 13:12

【摘要】：目的应用三维/实时三维容积超声评估低位产钳助产对女性盆底功能的影响,分析产钳助产在女性盆底功能障碍性疾病发生中的作用。方法选择我院通过低位产钳助产分娩后女性31例作为病例组,根据入组患者相关因素匹配选择同时期正常阴道分娩产妇31例作为对照组。两组患者均进行三维/实时三维盆底超声检查,分别在静息、Valsalva及提肛三个状态采集图像。进行残余尿、膀胱颈移动度、宫颈最低点、盆膈裂孔面积大小及观察肛提肌完整性的相关参数的测量。结果病例组中残余尿增多、膀胱颈移动度增大、盆膈裂孔增大发生率分别为3.2%、25.8%、38.7%,与对照组(发生率分别为3.2%、19.4%、35.4%)相比差异无统计学意义(P0.05)。病例组中子宫脱垂、肛提肌不同程度撕裂发生率分别为19.4%、38.7%,明显高于对照组(发生率0、9.7%),差异具有统计学意义(P=0.010、0.008)。结论低位产钳助产是引起女性盆底功能障碍的高危因素,三维/实时三维盆底超声检查观察子宫脱垂、肛提肌撕裂发生率可对盆底功能进行有效评估,从而及时诊断并指导临床。
[Abstract]:Objective to evaluate the effect of lower forceps delivery on female pelvic floor function by three-dimensional / real-time volume ultrasound, and to analyze the role of forceps in the development of female pelvic floor dysfunction. Methods 31 cases of women after delivery with low forceps in our hospital were selected as the case group and 31 cases of normal vaginal delivery as the control group according to the matching of the relevant factors of the patients in the group. Three-dimensional / real-time three-dimensional pelvic floor ultrasonography was performed in both groups. The images were collected in three states: Valsalva and levator anus. The residual urine, bladder neck mobility, the lowest point of cervix, the area size of pelvic and phrenic fissure and the relative parameters of observing the integrity of levator ani muscle were measured. Results in the case group, the incidence of residual urine, bladder neck mobility and pelvic and phrenic hiatus were 3.2and 25.8and 38.7, respectively. There was no significant difference compared with the control group (the incidence was 3.219.4%) (P0.05). The incidence of prolapse of uterus and tear of levator ani muscle were 19.4% and 38.7%, respectively, which were significantly higher than those in control group (0 9. 7%). The difference was statistically significant (P < 0. 010 ~ 0. 008). Conclusion low forceps delivery is a high risk factor for female pelvic floor dysfunction. Three-dimensional / real-time pelvic floor ultrasonography can be used to evaluate the pelvic floor function by observing uterine prolapse and laceration of levator ani muscle. Thus timely diagnosis and guidance of clinical.
【作者单位】：首都医科大学附属北京妇产医院超声科;
【分类号】：R445.1;R717

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