摘要
目的观察高频超声对产妇腹直肌、耻骨联合分离的预测价值。方法将208例经临床表现、体征和CT检查确诊的产后腹直肌、耻骨联合分离症患者作为观察组,根据分娩方式分为阴道分娩组(n=168)和剖宫产组(n=40),选取同期健康产妇100例作为对照A组,未孕妇女80例作为对照B组;观察组于产后第3天和第42天,对照A组于产后第3天,对照B组产检当日,采用高频超声测量耻骨联合分离指标(间距较宽处、间距较窄处、左右错合度)及腹直肌分离距离,采用受试者工作(ROC)曲线下面积(AUC)评价上述指标单一或联合预测产后腹直肌、耻骨联合分离的诊断价值。结果观察组耻骨联合分离间距较宽处、间距较窄处及左右错合度和腹直肌分离距离高于对照A组和对照B组(P<0.05),对照A组耻骨联合分离间距较宽处及左右错合度和腹直肌分离距离高于对照B组(P<0.05),但耻骨联合分离间距较窄处比较差异无统计学意义(P>0.05);ROC曲线分析显示,耻骨联合间距较宽处、间距较窄处、左右错合度及腹直肌分离距离联合预测产后腹直肌、耻骨联合分离的敏感度及AUC高于单一指标检测(P<0.05);阴道分娩组产妇腹直肌分离距离大于剖宫产组(P<0.05);观察组产妇产后第42天出现错合情况和强回声低于产后第3天(P<0.05)。结论高频超声诊断产后腹直肌、耻骨联合分离的价值较高。
Objective To investigate the predicting value of high-frequency ultra-sonograph for postpartum diastasis of rectus abdominis and pubis symphysis separation.Methods Two hundred and eight patients with postpartum diastasis of rectus abdominis and pubis symphysis separation,confirmed with clinical manifestation,physical signs,and CT check were chosen as observation group,and were divided into the vaginal delivery group(n=168)and the cesarean section group(n=40)according to the delivery method.One hundred healthy postpartum women were chosen as control group A and 80 non-pregnant women as control group B.The rectus abdominis gap distance,pubis symphysis separation distance(wide gap and narrow gap),and left-right disregistry were measured by high-frequency ultra-sonograph on the day of delivery for control group B,on 3^(rd) and 42^(nd) day after delivery for observation group,and 3^(rd) day after delivery for control group A.The AUC of ROC curve was used to evaluate the diagnostic value of previously mentioned indexes to predict postpartum diastasis of rectus abdominis and pubis symphysis separation individually or combined.Results The wide gap,narrow gap,left-right disregistry,and diastasis of rectus abdominis of the observation group were larger than those of both control groups(P<0.05).The wide gap,left-right disregistry and diastasis of rectus abdominis of control group A were larger than those of control group B(P<0.05),but there was no significant difference in narrow gap between the two(P>0.05).ROC curve analysis revealed that postpartum diastasis of rectus abdominis and pubis symphysis separation combined prediction of pubis and narrow/wide gap,left-right disregistry degree,diastasis gap of rectus abdominis,and pubis symphysis separation with higher sensitivity and AUC than single index detection(P<0.05).The diastasis distance of rectus abdominis in vaginal delivery group was higher than that of cesarean section group(P<0.05).The incidence of misfit and strong echo on the 42^(nd) day after delivery was lower t
作者
陈刚
吴清
CHEN Gang;WU Qing(Department of Ultra-sonograph,West China Guang'an Hospital,Sichuan University,Guang’an 638000,Sichuan,China)
出处
《贵州医科大学学报》
CAS
2022年第2期229-233,248,共6页
Journal of Guizhou Medical University
基金
重庆市科技计划项目(cstc2018jscx-msybX0383)。
关键词
腹直肌分离
耻骨联合分离
高频超声
诊断价值
腹直肌间距
diastasis rectus abdominis
pubis separation
high-frequency ultra-sonograph
diagnostic value
interval between rectus abdominis
