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广西医科大学第四附属医院/柳州市工人医院超声科
纸质出版日期:2016,
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[1]陈静,龚国芸,黄晴,练丹,李柳兰,邱洪凤.经会阴三维超声评估不同分娩方式对初产女性盆膈裂孔影响的临床价值[J].重庆医科大学学报,2016,41(07):703-707.
Chen Jing, Gong Guoyun, Huang Qing, et al. Clinical value of transvaginal three-dimensional ultrasound in assessing the influence of different delivery methods on the pelvic diaphragm hiatus in primipara[J]. Journal of Chongqing Medical University, 2016,41(7):703-707.
[1]陈静,龚国芸,黄晴,练丹,李柳兰,邱洪凤.经会阴三维超声评估不同分娩方式对初产女性盆膈裂孔影响的临床价值[J].重庆医科大学学报,2016,41(07):703-707. DOI: 10.13406/j.cnki.cyxb.000999.
Chen Jing, Gong Guoyun, Huang Qing, et al. Clinical value of transvaginal three-dimensional ultrasound in assessing the influence of different delivery methods on the pelvic diaphragm hiatus in primipara[J]. Journal of Chongqing Medical University, 2016,41(7):703-707. DOI: 10.13406/j.cnki.cyxb.000999.
目的:应用经会阴三维超声评价分析妊娠晚期女性盆膈裂孔(pelvic hiatus
PH)的形态结构。方法:选择2013年1月至2015年10月出院的剖宫产与经阴道分娩产妇各50例
分别列为剖宫产组与经阴道分娩组
进行经会阴三维超声检查
并选择同期妇科疾病体检的未育女性50例作为对照组
观察正常PH与分娩后PH超声学表现
比较两种不同分娩方式不同时间PH左右径、前后径及面积的变化特征。结果:(1)对照组PH形态:呈"菱形"
裂隙样结构;剖宫产组产妇分娩后PH与对照组形态一致24例(48)
其余26例PH形态呈"类椭圆形"。经阴道分娩组PH与对照组形态一致0例
均呈"类椭圆形"
超声影像提示PH内结构模糊
回声紊乱;(2)剖宫产组、经阴道分娩组产前静息状态、缩肛运动、瓦氏动作时PH左右径、前后径与面积均高于对照组(P<0.05)
剖宫产组产后6周、3个月较明显产前缩小(P<0.05)
经阴道分娩组产后三种状态下PH左右径、前后径与面积显著增大
3个月后减小
但均大于产前、对照组及剖宫产组(P<0.05)
3个月后缩肛运动、瓦氏动作时PH左右径、前后径与面积高于剖宫产组(P<0.05)。结论:经会阴三维超声可清晰观察女性盆底结构
2种分娩方式均对女性PH具有影响
其中经阴道分娩影响较为显著。
Objective:To evaluate the morphological structure of the female pelvic hiatus(PH)in the late pregnancy by transvaginal three-dimensional ultrasound. Methods:Fifty cases of cesarean section delivery and 50 cases of vaginal delivery discharged from the hospital from January 2012 to December 2014 were taken as cesarean section group and vaginal delivery group and were checked by transvaginal three-dimensional ultrasound. Fifty cases of nulliparous women with gynecological diseases examination in the same period were taken as control group. Ultrasound findings of normal PH and PH after delivery were observed. The variation characteristics of PH left and right diameter
front back diameter and area between two different delivery methods in different time points were compared. Results:(1) PH morphology in control group was in diamond-shaped fissure structure;PH morphology of cesarean section group after delivery was consistent with that of control group(24 cases/48 cases)
and the PH morphology of the remaining 26 cases was fuzzy in structure with echo disorder.(2)PH left-right diameter
anteroposterior diameter and area at the prenatal resting state
anal contraction movement
and Valsalva maneuver were higher in cesarean section delivery group and vaginal delivery group than in control group(P<0.05). In cesarean section delivery group
the above indexes were lower at 6 weeks and 3 months after delivery than before delivery(P<0.05). In vaginal delivery group
the above indexes were increased after delivery and were decreased from the 3 rd month after delivery;the above indexes were higher in vaginal delivery group after delivery than in vaginal delivery group before delivery
cesarean section delivery group
and control group(P <0.05). Conclusion:Three dimensional ultrasound can clearly observe the female pelvic floor structure.Both delivery modes exert effect on the female pelvic diaphragm hiatus;the effect of the vaginal delivery is more significant.
经会阴三维超声剖宫产分娩经阴道分娩盆膈裂孔
transperineal three-dimensional ultrasoundcesarean section deliveryvaginal deliverypelvic hiatus
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