超声检测初产不同分娩方式后6~12周女性双侧腹直肌间距

Ultrasonic Examination of the Inter-Rectus Distance in Women at 6 to 12 Weeks after Different Delivery Modes

摘要: 目的：运用超声检测产后6~12周女性双侧腹直肌间距，评估不同分娩方式后6~12周女性双侧腹直肌间距改变情况，探讨其临床意义。方法：运用超声对51例初产顺产后女性(顺产组)、51例初产剖宫产后女性(剖宫产组)和50名健康未孕未产女性(对照组)行双侧腹直肌间距检测，详细测量剑突下3 cm水平、脐上3 cm水平、脐部水平、脐下3 cm水平及耻骨上3 cm水平共上中下腹区域5个水平的双侧腹直肌间距距离，并进行比较分析。结果：超声可定量测量健康未孕未产女性和产后女性的双侧腹直肌间距距离。顺产组和剖宫产组5个水平的双侧腹直肌间距距离均大于对照组，差异有统计学意义(P均<0.05)。顺产组和剖宫产组间中上腹区域3个水平(剑突下3 cm水平、脐上3 cm水平、脐部水平)产后6~12周双侧腹直肌间距距离差异无统计学意义(P均>0.05)。剖宫产组下腹区域2个水平(脐下3 cm水平和耻骨上3 cm水平)产后6~12周双侧腹直肌间距距离大于顺产组产后6~12周双侧腹直肌间距距离，差异有统计学意义(P均<0.05)。结论：超声是定量评估健康未孕未育女性和产后女性双侧腹直肌间距的良好工具，能为临床产后康复提供重要信息。初产不同分娩方式后6~12周5个水平的双侧腹直肌间距均较健康未孕未产女性明显增加，初产剖宫产后6~12周下腹区域双侧腹直肌间距距离较初产顺产后更宽。

Abstract: Objective: To evaluate the changes of the inter-rectus distance in women at 6 to 12 weeks after different delivery modes, and to explore its clinical significance. The inter-rectus distance was detected by ultrasound at 6~12 weeks postpartum. Methods: The inter-rectus distance was detected by ultrasound in 51 women after initial vaginal delivery (vaginal delivery group), 51 women after initial cesarean section (cesarean section group) and 50 healthy non-pregnant and nulliparous women (control group). The examination was practiced 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 pubis. The distance was compared and analyzed. Results: Ultrasound was used to quantitatively measure the inter-rectus distance in healthy non-pregnant and nulliparous women and postpartum women. The inter-rectus distance of the vaginal delivery group and the cesarean section group was greater than that of the control group, and the difference was statistically significant (all P < 0.05). There was no significant difference in the distance between the three levels of middle and upper abdominal region (3 cm below the xiphoid, 3 cm above the umbilicus, the umbilicus) between the vaginal delivery group and the cesarean section group at 6 to 12 weeks postpartum (all P > 0.05). The inter-rectus distance at two levels (3 cm below the umbilicus and 3 cm above the pubis) of the cesarean section group at 6 to 12 weeks after delivery was greater than that of the vaginal delivery group, and the difference was statistically significant (all P < 0.05). Conclusion: Ultrasound is a good tool for measuring the inter-rectus distance in women, which can be used to quantitatively evaluate the inter-rectus distance in healthy non-pregnant and nulliparous women and postpartum women, and can provide important information for the clinical postpartum rehabilitation. The inter-rectus distance at 5 levels at 6~12 weeks after the first delivery with different delivery modes was significantly increased compared with that of healthy non-pregnant and nulliparous women. At 6~12 weeks after cesarean section, the inter-rectus distance in the lower abdominal region was wider than that after vaginal delivery.