经会阴盆底超声评估妊娠及阴道分娩对盆底功能的影响

Analysis by Pelvic Ultrasonography on the Impact of Pregnant and Vaginal Delivery on the Pelvic Floor Function

摘要: 目的：通过对孕妇、经阴道分娩女性以及正常未生育女性的盆底超声检查，探讨经会阴部盆底超声检查对女性盆底功能障碍性疾病的诊断价值，分析不同时段孕期对女性盆底功能的影响。方法：研究对象为2015年7月~2016年7月在我院进行产检的24周、37周孕妇及在我院经阴道分娩产妇共60例，年龄20~40岁，平均(29.31 ± 2.93)岁。将检查者分为三组，A组：孕中期孕妇(孕24周)；B组：孕足月孕妇(孕37周)；C组：足月经阴道分娩产妇(产后14天)；D组：未生育妇女(空白对照)，分别对其进行经会阴盆底超声检查，选择从静息至Valsalva状态下测量产妇的膀胱颈移动度、宫颈外口移动度、直肠移动度、肛提肌裂孔面积。将测量结果记录并存图，运用SPSS18.0统计学软件进行数据分析。结果：孕中期组、孕足月组及产后组压力性尿失禁及盆底器官脱垂情况发生率均高于对照组，差异有统计学意义(P < 0.05)；孕晚期组、产后组各组测值比孕中期均明显增大，差异有统计学意义(P < 0.05)；孕晚期组与产后组各测值无明显差异，差异无统计学意义(P > 0.05)。结论：孕期及经阴道分娩过程对妇女的盆底功能均有影响，其女性盆底功能障碍性疾病发生率明显高于未生育妇女。

Abstract: Objective: To explore the diagnostic value of pelvic floor ultrasound in female pelvic floor dys-function through pelvic floor ultrasonography with the pregnant women, vaginal delivery women and normal non pregnant women. To analyze the effect of different time on female pelvic floor function during pregnancy. Methods: 20 women with Vaginal Delivery in the our hospital, 20 pregnancy women with 24 weeks, 20 pregnancy women with 37 weeks and 20 normal non preg-nant women were enrolled in this study from July 2015 to July 2016. They were at the age of 20 to 35 and averaged (29.31 ± 2.93). Inspectors will be divided into four groups. Group A: pregnancy women with 24 weeks; Group B: pregnancy women with 37 weeks; Group C: pregnancy women; Group D: non pregnant women. Then they accepted the perineal pelvic ultrasonography. Perineum ultrasound was examined at both resting position and valsalva position and the following data were measured: bladder neck down distance (BND), the cervix down distance (CD), the rectal ampulla down distance (RAD) between resting position and valsalva position. The measurement results were recorded with graph. Data were analyzed by using SPSS18.0 statistical software. Results: The incidence of stress urinary incontinence and pelvic organ prolapse in the Groups A, B and C is higher than the other. The p < 0.05 difference has statistics significance; The Group B and Group C has no obvious difference was found between the measured values. The p > 0.05 difference has no statistics significance. Conclusion: Pregnancy and vaginal delivery has influence on the pelvic floor function. The incidence of female pelvic floor functional disorder is significantly higher than non pregnant women.