高频超声测量健康未孕未育女性两侧腹直肌间距的应用研究

Application of High Frequency Ultrasound in Measurement of the Bilateral Rectus Abdominis Distance in Healthy and Non-Pregnant and Nulliparous Women

摘要: 目的：同一医师不同时间及不同医师间应用高频超声测量健康未孕未育女性多个水平的两侧腹直肌间距，评估高频超声检测健康未孕未育女性两侧腹直肌间距的临床意义。方法：医师甲、医师乙运用高频超声先后测量125名健康未孕未育女性剑突下3 cm、脐上3 cm、脐部、脐下3 cm、耻骨上3 cm水平的两侧腹直肌间距，半小时后医师甲第二次测量，记录并比较分析。结果：125名健康未孕未育女性剑突下3 cm、脐上3 cm、脐部、脐下3 cm、耻骨上3 cm水平两侧腹直肌间距分别为4.03 ± 2.36 mm、6.76 ± 3.51 mm、10.51 ± 3.72 mm、0.92 ± 0.99 mm、0.86 ± 0.70 mm。相邻的剑突下3 cm与脐上3 cm、脐上3 cm与脐部、脐部与脐下3 cm水平间两侧腹直肌间距差异有统计学意义(t = −11.310, −10.965, 27.744，P均<0.001)；脐下3 cm与耻骨上3 cm水平两侧腹直肌间距差异无统计学意义(t = 0.610, P = 0.543)。同一医师不同时间测量各水平两侧腹直肌间距的一致性好(ICC均>0.75)；不同医师间测量耻骨上3 cm水平两侧腹直肌间距一致性一般(ICC = 0.715)，测量其余各水平两侧腹直肌间距一致性好(ICC均>0.75)。结论：高频超声可准确多水平测量健康未孕未育女性的两侧腹直肌间距，两侧腹直肌间距由宽至窄依次为脐部、脐上3 cm、剑突下3 cm、脐下3 cm、耻骨上3 cm水平。超声测量双侧腹直肌间距可重复性好，是定量测量两侧腹直肌间距的可靠影像学检查方法，值得临床广泛推广应用。

Abstract: Objective: To explore the application value of high frequency ultrasonic in measuring the bilateral rectus abdominis distance in healthy and non-pregnant and nulliparous women by the same doctor at different times and between different doctors. Methods: Doctor A and Doctor B independently examined the distance of the bilateral rectus abdominis in 125 healthy and non-pregnant and nulliparous women at five Levels: 3 cm below the xiphoid and 3 cm above the umbilicus and the umbilicus and the 3 cm below the umbilicus and 3 cm above the pubic bone. Half an hour later, Doctor A examined the distance of the bilateral rectus abdominis again. The distance was recorded and compared statistically. Results: The mean distance of the bilateral rectus abdominis was 4.03 ± 2.36 mm at 3 cm below the xiphoid and 6.76 ± 3.51 mm at 3 cm above the umbilicus and 10.51 ± 3.72 mm at the umbilicus and 0.92 ± 0.99 mm at 3 cm below the umbilicus and 0.86 ± 0.70 mm at 3 cm above the pubis. There was statistically significant difference in the mean distance of the bilateral rectus abdominis at the level of 3 cm below the xiphoid and 3 cm above the umbilicus, and at the level of the umbilicus and 3 cm below the umbilicus (t = −11.310, −10.965, 27.744, all P < 0.001). There was no significant difference in the distance of the bilateral rectus abdominis at the level of 3 cm below the umbilicus and 3 cm above the pubis (t = 0.610, P = 0.543). The same doctor measured the distance of the bilateral rectus abdominis at different levels at different times had good consistence (all ICC > 0.75). The different doctors (except for the level of 3 cm above the pubis) measured the distance of the bilateral rectus abdominis at different levels had good consistence (all ICC > 0.75). Conclusion: The distance of the bilateral rectus abdominis in healthy and non-pregnant and nulliparous women can be accurately measured in multiple levels by the high frequency ultrasound technology. This imaging method has the advantages of good quantification and reproducibility and worthy of clinical application. The distance of the bilateral rectus abdominis from wide to narrow was at the level of umbilical and 3 cm above the umbilical and 3 cm below the xiphoid and 3 cm below the umbilical and 3 cm above the pubis.