国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2014年
10期
1413-1416
,共4页
三维超声%分娩方式%初产妇%盆腔器官脱垂%肛提肌裂孔
三維超聲%分娩方式%初產婦%盆腔器官脫垂%肛提肌裂孔
삼유초성%분면방식%초산부%분강기관탈수%항제기렬공
Three-dimensional ultrasonography%Delivery mode%Primipara%Pelvic organ prolapse%Levator hiatal
目的 了解不同分娩方式对初产妇产后的盆底解剖与功能变化的影响.方法 选取我院妇产科选择性剖宫产(剖宫产组)和经阴道分娩(顺产组)的初产妇各250例,于产后6～8周进行盆底三维超声检查.观察Valsalva动作时前、中、后盆腔有无器官脱垂并测量膀胱颈下移距离、尿道旋转角度等参数,观察静息、缩肛动作、Valsalva动作时肛提肌裂孔的变化并测量其面积.结果 顺产组出现盆腔器官脱垂的病例数明显多于剖宫产组(P＜0.05),且脱垂的严重程度也明显重于剖宫产组(P＜0.05);顺产组在Valsalva动作时,膀胱颈下移距离、尿道旋转角度均大于剖宫产组(P＜0.05);顺产组在静息、缩肛动作及Valsalva动作时其肛提肌裂孔的面积均大于剖宫产组(P＜0.05).结论 经阴道顺产对盆底结构和功能的损伤大于剖宫产组,盆底三维超声是产后筛查盆底功能障碍性疾病的一项客观而简单且值得推广的影像学方法.
目的 瞭解不同分娩方式對初產婦產後的盆底解剖與功能變化的影響.方法 選取我院婦產科選擇性剖宮產(剖宮產組)和經陰道分娩(順產組)的初產婦各250例,于產後6～8週進行盆底三維超聲檢查.觀察Valsalva動作時前、中、後盆腔有無器官脫垂併測量膀胱頸下移距離、尿道鏇轉角度等參數,觀察靜息、縮肛動作、Valsalva動作時肛提肌裂孔的變化併測量其麵積.結果 順產組齣現盆腔器官脫垂的病例數明顯多于剖宮產組(P＜0.05),且脫垂的嚴重程度也明顯重于剖宮產組(P＜0.05);順產組在Valsalva動作時,膀胱頸下移距離、尿道鏇轉角度均大于剖宮產組(P＜0.05);順產組在靜息、縮肛動作及Valsalva動作時其肛提肌裂孔的麵積均大于剖宮產組(P＜0.05).結論 經陰道順產對盆底結構和功能的損傷大于剖宮產組,盆底三維超聲是產後篩查盆底功能障礙性疾病的一項客觀而簡單且值得推廣的影像學方法.
목적 료해불동분면방식대초산부산후적분저해부여공능변화적영향.방법 선취아원부산과선택성부궁산(부궁산조)화경음도분면(순산조)적초산부각250례,우산후6～8주진행분저삼유초성검사.관찰Valsalva동작시전、중、후분강유무기관탈수병측량방광경하이거리、뇨도선전각도등삼수,관찰정식、축항동작、Valsalva동작시항제기렬공적변화병측량기면적.결과 순산조출현분강기관탈수적병례수명현다우부궁산조(P＜0.05),차탈수적엄중정도야명현중우부궁산조(P＜0.05);순산조재Valsalva동작시,방광경하이거리、뇨도선전각도균대우부궁산조(P＜0.05);순산조재정식、축항동작급Valsalva동작시기항제기렬공적면적균대우부궁산조(P＜0.05).결론 경음도순산대분저결구화공능적손상대우부궁산조,분저삼유초성시산후사사분저공능장애성질병적일항객관이간단차치득추엄적영상학방법.
Objective To investigate the influence of different modes of delivery on primiparae's pelvic floor structure and function change.Methods 250 cases delivering through caesarean section (C-section group) and 250 cases delivering vaginally (natural labor group) were chosen,then their pelvic floors were checked by three-dimensional uhrasonography 6-8 weeks after the delivery.The signs of anterior,middle,and posterior pelvic prolapse were observed and the bladder neck down distance and the urethral transfer angle were measured during Valsalva maneuver.The changes were observed and the areas of levator hiatal were measured when the patients was in rest,Shrinkage anal maneuver,and Valsalva maneuver.Results More cases occurred more severe pelvic organ prolapse in the natural labor group than in the C-section group (P ＜ 0.05).During Valsalva maneuver,the bladder neck down distance was longer and the urethral teansfer angle was larger in the natural labor group than in the C-section group (P ＜ 0.05).When the patients were in rest,Shrinkage anal maneuver,and Valsalva maneuver,the areas of levator hiatal were larger in the natural labor group than in the C-section group (P ＜ 0.05).Conclusions Natural labor is more harmful to primiparae's pelvic floor structure and function than C-section.Three-dimensional ultrasonography is a simple and objective method for postpartum pelvic floor dysfunction screening and worth being generalized.
