目的：探讨四维盆底超声评估生产方式及胎次对盆膈裂孔的影响。方法：收集2015年11月—2016年4月在我院妇产科分娩并于产后42 d至门诊复查的患者102例，分为阴道分娩组和选择性剖宫产组，两组各自按照胎次分为单产次组和多产次组，同时选择健康成年女性30名作为对照组。采用四维超声分别对产后42 d的女性进行静息状态下、盆腔最大用力（Valsalva）动作状态下盆膈裂孔的测量，观察盆膈裂孔的左右径（LHLR）、前后径（LHAP）、面积（LHA）。结果：①3组研究对象在静息状态下和Valsalva状态下盆膈裂孔的LHAP、LHLR、LHA差异均有统计学意义（P<0.05），且阴道分娩组的各指标水平明显高于其他两组，剖宫产组高于对照组。②静息状态下和Valsalva状态下阴道分娩多胎组的盆膈裂孔的LHAP、LHLR、LHA明显高于单胎组（P<0.05），而剖宫产多胎组的盆膈裂孔的LHAP、LHLR、LHA明显高于单胎组。结论：阴道分娩方式和多胎次分娩对盆底功能损伤较大，产后经四维超声可及时发现盆底功能障碍，对指导临床有重要作用。
Abstract
Objective: To evaluate the influence of different ways of delivery and times of parity on female pelvic diaphragm hiatus with 4-dimensional ultrasound. Methods: One hundred and two puerperae were recruited who underwent delivery in hospital and visited clinic after 42 days postpartum from November 2015 to April 2016. Those patients were divided into different groups according to the ways of delivery and times of parity. Thirty healthy adult females were recruited as controls. The diameter, transverse diameter and area of pelvic diaphgragm hiatus in resting and Valsalva state were measured with 4-dimension ultrasound on all subjects. Results: ①Significant differences were found in the diameter, transverse diameter and area of pelvic diaphgragm hiatus in resting and Valsalva states among all groups, and the vaginal delivery group had the largest size of pelvic diaphragm hiatus. ②Patients with multi-times of parity had larger diameter, transverse diameter and area of pelvic diaphgragm hiatus in resting and Valsalva states. Conclusions: Vaginal delivery and multi-times of parity cause larger damage to pelvic floor function and 4-demensioanl ultrasonography could be effective method to diagnose pelvic floor function injury.
关键词
骨盆底 /
膈 /
超声检查
Key words
Pelvic floor /
Diaphragm /
Ultrasonography
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