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Received:July 16, 2022 Published Online:March 20, 2023
Received:July 16, 2022 Published Online:March 20, 2023
中文摘要: 目的 探讨经阴道四维超声评估不同分娩方式对高龄产妇盆底功能的影响。方法 回顾性分析2017年12月至2020年12月期间唐山市妇幼保健院收治的300例高龄产妇的临床资料,根据分娩方式将产妇分为顺产组(n=150)和剖宫产组(n=150),两组产妇均于产后49 d进行经阴道四维超声检查,分析不同分娩方式对盆底功能的影响。结果 缩肛动作时,〖JP2〗剖宫产组尿道旋转角和膀胱颈移动度均明显高于顺产组(P<0.05)。静息条件下,两组宫颈外口至耻骨联合距离、膀胱颈至耻骨联合距离、膀胱尿道后角、尿道倾斜角和提肛肌夹角的比较差异无统计学意义(P>0.05)。最大Valsalva条件下剖宫产组宫颈外口至耻骨联合距离、膀胱颈至耻骨联合距离,均明显大于顺产组,膀胱尿道后角、尿道倾斜角和提肛肌夹角均明显低于顺产组,差异有统计学意义(P<0.05)。结论 经阴道四维超声检测显示剖宫产对高龄产妇盆底功能的影响较小;四维超声可诊断盆底病变程度,且费用低廉、可反复检查,应重视提高产妇围产期盆底功能检测的意识,以对盆底功能性疾病进行早期诊断和干预。
Abstract:Objective To evaluate the effect of different delivery methods on pelvic floor function in women of advanced maternal age by transvaginal four-dimensional ultrasound. Methods The clinical data of 300 women (aged ≥ 35 years old), admitted to Tangshan Maternal and Child Health Hospital from December 2017 to December 2020 were retrospectively analyzed. According to the mode of delivery, the women were divided into spontaneous delivery group (n=150) and cesarean section group (n=150). The puerperas were examined by transvaginal four-dimensional ultrasound on the 49th day after delivery to analyze the effect of different delivery modes on pelvic floor function in two groups. Results During anal sphincter contraction, the urethra rotation angle and bladder neck mobility in cesarean section group were significantly higher than spontaneous delivery group (P<0.05). Under resting conditions, there was no significant difference in the distance from cervical mouth position (CMP) to pubic symphysis, the distance from bladder neck position (BNP) to pubic symphysis, the posterior urethra-vesical angle (PUA), urethra tilt angle (UTA) and anal muscle clamp angle (levator ani muscles angle) between two groups (P>0.05). Under the maximum Valsalva motion, the distances between CMP and pubic symphysis and between BNP and pubic symphysis in cesarean section group were significantly smaller than those in delivery group (P<0.05), and PUA, UTA and anal muscle clamp angle were significantly lower than those in delivery group (P<0.05). Conclusion Transvaginal four-dimensional ultrasound shows little effect on the pelvic floor function of older pregnant women and can determine the degree of pelvic floor disorders. With a low-cost and simple method, four-dimensional ultrasound can be used repeatedly for early diagnosis and intervention of pelvic floor functional diseases in women of advanced maternal age.
keywords: Four-dimensional ultrasound Delivery mode Spontaneous delivery Cesarean section Advanced maternal age Pelvic floor function
文章编号: 中图分类号:R414.5 R714.6 文献标志码:B
基金项目:河北省医学科学研究课题(20211407)
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