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目的应用三维/实时三维容积超声评估低位产钳助产对女性盆底功能的影响,分析产钳助产在女性盆底功能障碍性疾病发生中的作用。方法选择我院通过低位产钳助产分娩后女性31例作为病例组,根据入组患者相关因素匹配选择同时期正常阴道分娩产妇31例作为对照组。两组患者均进行三维/实时三维盆底超声检查,分别在静息、Valsalva及提肛三个状态采集图像。进行残余尿、膀胱颈移动度、宫颈最低点、盆膈裂孔面积大小及观察肛提肌完整性的相关参数的测量。结果病例组中残余尿增多、膀胱颈移动度增大、盆膈裂孔增大发生率分别为3.2%、25.8%、38.7%,与对照组(发生率分别为3.2%、19.4%、35.4%)相比差异无统计学意义(P>0.05)。病例组中子宫脱垂、肛提肌不同程度撕裂发生率分别为19.4%、38.7%,明显高于对照组(发生率0、9.7%),差异具有统计学意义(P=0.010、0.008)。结论低位产钳助产是引起女性盆底功能障碍的高危因素,三维/实时三维盆底超声检查观察子宫脱垂、肛提肌撕裂发生率可对盆底功能进行有效评估,从而及时诊断并指导临床。
Objective To evaluate the effect of low forceps midwifery on pelvic floor function in patients with pelvic floor dysfunction by three-dimensional / real-time three-dimensional volume ultrasound. Methods Select 31 cases of female postpartum delivery by low forceps in our hospital as the case group. According to the relevant factors of the patients, 31 cases of normal vaginal delivery during the same period were selected as the control group. Three groups of patients underwent three-dimensional / real-time three-dimensional pelvic floor ultrasound examination, respectively, at rest, Valsalva and levator ani three state acquisition images. Residual urine, bladder neck mobility, cervical lowest point, the size of the diaphragm diaphragm hole size and observe the integrity of the levator ani measured parameters. Results The residual urine increased, the mobility of the bladder neck increased and the incidence of pelvic diaphragm hiatus increased by 3.2%, 25.8% and 38.7% respectively in the case group (the incidence rates were 3.2%, 19.4% and 35.4% respectively) Compared with no significant difference (P> 0.05). In the case group, the rates of uterine prolapse and levator ani were 19.4% and 38.7%, respectively, which were significantly higher than those in the control group (the incidence was 0.9%) (P = 0.010 and 0.008 respectively) . Conclusions Low forceps midwifery is a risk factor for women with pelvic floor dysfunction. Three-dimensional / real-time three-dimensional pelvic floor ultrasound to observe the incidence of uterine prolapse and levator ani muscle tear can effectively evaluate the function of the pelvic floor, which promptly diagnoses and guides clinical.