经会阴实时三维盆底超声评估不同分娩方式对产后女性前腔室结构和盆膈裂孔的影响

摘要 目的：探讨经会阴实时三维盆底超声评估不同分娩方式对产后女性前腔室结构和盆膈裂孔的影响。方法：回顾性分析2015年1月至2019年10月在我院接受检查的100例产妇的诊治资料。根据分娩方式的不同，将患者分为经阴道分娩组（n=55）和剖宫产分娩组（n=45）。比较两组产妇在静息状态和Valsalva状态下的前腔室和盆膈裂孔超声参数。结果：在静息状态下，两组的膀胱颈位置、逼尿肌厚度、膀胱后角和尿道倾斜角相比无差异（P>0.05）。经阴道分娩组在Valsalva状态下的膀胱颈移动度和尿道旋转角均大于剖宫产分娩组，尿道内口漏斗形成率和膀胱膨出率均高于剖宫产分娩组（P<0.05）。在Valsalva状态下，经阴道分娩组的盆膈裂孔前后径、左右径、面积和周长均大于剖宫产分娩组（P<0.05）；在静息状态下，两组的上述指标相比，差异均无统计学意义（P>0.05）。结论：应用经会阴实时三维盆底超声技术观察产妇前腔室结构和盆膈裂孔的参数变化，可评估产妇盆底功能受损的程度，经阴道分娩对其影响较大。

Real Time Three-dimensional Pelvic Floor Ultrasound Through Perineum to Evaluate the Effect of Different Delivery Methods on the Structure of Anterior Chamber and the Hole of Pelvic Diaphragm in Postpartum Women

ABSTRACT Objective: To evaluate the Real time three-dimensional pelvic floor ultrasound through perineum to evaluate the effect of different delivery methods on the structure of anterior chamber and the hole of pelvic diaphragm in postpartum women. Methods: The data of diagnosis and treatment of 100 cases of parturient examined in our hospital from January 2015 to October 2019 were analyzed retrospectively. According to different delivery methods, the patients were divided into vaginal delivery group (n=55) and cesarean delivery group (n=45). The ultrasonic parameters of the anterior chamber and pelvic diaphragm hiatus in resting state and Valsalva state were compared between the two groups. Results: There was no significant difference between the two groups in the position of bladder neck, detrusor thickness, posterior angle of bladder and urethra inclination angle in resting state (P>0.05). In the vaginal delivery group, the mobility of the cystis neck and the rotation angle of the urethra were higher than those in the cesarean delivery group, and the formation rate of the internal urethra funnel and cystocele were higher than those in the cesarean delivery group (P<0.05). In the Valsalva state, the diameter, area and perimeter of the pelvic diaphragmatic hole in the vaginal delivery group were larger than those in the cesarean delivery group (P<0.05). In resting state, the difference between the two groups was not statistically significant (P>0.05). Conclusion: The perineal real-time three-dimensional pelvic floor ultrasound is applied to observe the changes of parameters of the anterior chamber structure and pelvic diaphragm hiatus, and the degree of pelvic floor function damage could be evaluated, the effect of vaginal delivery is greater.