经会阴动态三维超声对便秘的产后女性盆底解剖结构重塑的观察

发布时间：2019-06-12 13:25

【摘要】：目的经会阴盆底三维超声动态观察便秘产妇的肛提肌裂孔解剖形态重塑及功能改变。方法选取2014年7月至2017年6月在我院妇产科定期行产后复查的女性110例(产后组),其中有便秘症状45例(便秘产妇),无便秘症状65例(无便秘产妇),同期选取未育的无便秘症状健康妇女100例(对照组)。所有妇女均进行经会阴盆底三维超声检查,观察并测量比较各组妇女的盆底解剖形态结构及特征,测量各组妇女在静息状态、缩肛动作和Valsalva动作3种状态下的肛提肌裂孔面积、周长及肛提肌厚度。结果产后妇女盆底组织结构疏松,对照组妇女肛提肌裂孔结构完整紧凑。在静息状态、缩肛动作及Valsalva动作3种状态下,产后组妇女的肛提肌裂孔面积、周长及肛提肌厚度均明显大于对照组妇女,差异均有统计学意义(P0.05)。产后组便秘产妇在3种状态下的肛提肌裂孔面积及周长均明显大于无便秘产妇(P0.05);在缩肛动作时便秘产妇的肛提肌厚度明显薄于无便秘产妇(P0.05),在静息状态及Valsalva动作时,便秘产妇与无便秘产妇的肛提肌厚度比较,差异均无统计学意义(P0.05)。结论产后妇女盆底解剖结构发生重塑,经会阴三维超声能有效观察产后女性尤其便秘产妇盆底解剖结构与功能的变化。
[Abstract]:Objective to observe the anatomical morphology and functional changes of anal levator muscle foramen in constipation parturients by three-dimensional ultrasound at perineal floor. Methods from July 2014 to June 2017, 110 women (postpartum group) who were regularly reexamined after delivery in obstetrics and gynecology department of our hospital were selected, including 45 women with constipation symptoms (constipation parturients), 65 women without constipation symptoms (no constipation parturients), and 100 infertile healthy women without constipation symptoms (control group). All women underwent three-dimensional ultrasound examination of perineal floor, observed and compared the anatomical structure and characteristics of pelvic floor of women in each group, and measured the foramen area, circumference and thickness of levator anal muscle in resting state, anal contraction action and Valsalva action. Results the pelvic floor tissue structure of postpartum women was loose, and the structure of anal levator muscle foramen in control group was complete and compact. In resting state, anal contraction action and Valsalva action, the foramen area, circumference and thickness of levator anal muscle in postpartum group were significantly higher than those in control group (P 0.05), and the area, circumference and thickness of levator anal muscle in postpartum group were significantly higher than those in control group (P 0.05). The area and circumference of anal levator muscle in postpartum group were significantly larger than those in non-constipation parturients (P 0.05); the thickness of anal levator muscle in constipation parturients was significantly thinner than that in non-constipation parturients during anal contraction (P 0.05). In resting state and Valsalva action, there was no significant difference in anal levator muscle thickness between constipation parturients and non-constipation parturients (P 0.05). Conclusion the anatomical structure of pelvic floor of postpartum women is reshaped. Three-dimensional ultrasound of perineum can effectively observe the changes of anatomical structure and function of pelvic floor of postpartum women, especially those with constipation.
【作者单位】：西安交通大学医学院第三附属医院陕西省人民医院超声诊断中心;西安交通大学医学院第三附属医院陕西省人民医院妇产病院;
【基金】：国家自然科学基金青年项目(81501238) 陕西省科技厅科学技术研究发展计划项目(2014K11-03-09-06)
【分类号】：R445.1;R714.6

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