经会阴三维超声检查在阴道分娩初产妇产后盆底功能评估中的应用价值

Application of Perineal Three-Dimensional Ultrasound Examination in Postpartum Pelvic Floor Function Evaluation

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摘要【目的】探讨经会阴三维超声检查在阴道分娩初产妇产后盆底功能评估中的应用价值。【方法】选取2021年1月至2023年1月在西安济仁医院分娩的80例阴道分娩产妇为研究对象,根据产后是否出现盆底功能障碍分为正常组(n=63)和障碍组(n=17)。两组均检测盆底肌肉张力指标[阴道静息压(VRP)、阴道收缩压(VSP)与阴道收缩持续时间]和尿道功能指标(功能性尿道长度和最大尿道关闭压);采用经会阴三维超声检测静息状态、最大Valsalva状态下的盆底功能相关参数[膀胱颈位置(BNP)、膀胱颈移动度(BND)],采用受试者工作特征(ROC)曲线分析其对阴道分娩初产妇产后盆底功能障碍的评估价值。【结果】正常组盆底肌肉张力和尿道功能指标均显著优于障碍组(P<0.05),且两组盆底功能相关参数比较,差异有统计学意义(P<0.05)。ROC曲线分析结果显示:BNP、BND单独及联合评估产后盆底功能障碍的曲线下面积均>0.7,具有一定的评估价值,且联合评估效果最佳。【结论】经会阴三维超声检查在阴道分娩初产妇产后盆底功能评估中的临床价值较高。【Objective】To evaluate the application of three dimensional transperineal ultrasonography in the prediction of pelvic floor function in parturient during vaginal delivery.【Methods】A total of 80 vaginal parturient who gave birth in Xi'an Jiren Hospital from January 2021 to January 2023 were selected as the study objects.They were divided into normal group(n=63)and disabled group(n=17)according to whether they had pelvic floor dysfunction after delivery.Pelvic floor muscle tension indices[vaginal resting pressure(VRP),vaginal systolic pressure(VSP)and duration of vaginal contraction]and urethral function indices(functional urethral length and maximum urethral closing pressure)were measured in both groups.The parameters related to pelvic floor function[bladder neck position(BNP),bladder neck mobility(BND)]in resting state and maximum Valsalva state were detected by transperineal three-dimensional ultrasound,and the evaluation value of pelvic floor dysfunction in puerperal parturient was analyzed by receiver operating characteristic(ROC)curve.【Results】The pelvic floor muscle tension and urethral function indexes of the normal group were significantly better than those of the disabled group(P<0.05),and the relevant parameters of the pelvic floor function were significantly different between the two groups(P<0.05).ROC curve analysis results showed that the area under the curve of BNP,BND alone and combined assessment of postpartum pelvic floor dysfunction were all>0.7,which had a certain evaluation value,and the combined assessment effect was the best.【Conclusion】Three-dimensional perineal ultrasonography is of high clinical value in evaluating pelvic floor function of parturient after vaginal delivery.

作者刘青萍马静 LIU Qingping;MA Jing(Department of Ultrasound,Xi'an Jiren Hospital,Xi'an Shaanxi 710300;不详)

机构地区西安济仁医院超声科宝鸡市妇幼保健院超声医学科

出处《医学临床研究》 CAS 2024年第9期1365-1367,1371,共4页 Journal of Clinical Research

关键词自然分娩超声检查会阴骨盆底 Natural Childbirth Ultrasonography Perineum Pelvic Floor

分类号 R714.3 [医药卫生—妇产科学]