摘要
本研究探讨具有剖宫产病史的瘢痕子宫再次妊娠实施剖宫产后盆底结构、盆底功能及肌力特征。选取100例瘢痕子宫再次妊娠且实施剖宫产手术的产妇作为观察组,再选取100例同期接受剖宫产手术分娩的初产妇作为对照组。采用经会阴盆底超声检查,对两组患者静息状态至Valsalva状态下的盆腔脏器移动参数、肛提肌厚度、盆膈裂孔参数及肌力进行评估对比。观察组静息状态至Valsalva状态下的膀胱颈移动距离、子宫颈外口移动距离、直肠壶腹移动距离均大于对照组(P<0.05);静息状态、Valsalva状态、缩肛状态下,观察组产妇肛提肌厚度小于对照组,同时,盆腔裂孔横径、盆腔裂前后径、盆腔裂孔面积大于对照组(P<0.05);观察组产妇的盆底肌Ⅰ类肌纤维和Ⅱ类肌纤维表面电信号小于对照组,观察组产妇的阴道压力异常、盆底肌肌力异常患者占比大于对照组(P<0.05);产后2周,观察组改良牛津肌力分级(MOS)盆底肌肌力分级整体低于对照组(P<0.05)。具有剖宫产病史的瘢痕子宫再次妊娠实施剖宫产后盆底结构、盆底功能及肌力较首次剖宫产产妇损伤更加严重,应该针对这部分人群加强产后康复。
This study investigated the characteristics of pelvic floor structure,pelvic floor function and muscle strength after cesarean section in re-pregnancy with scar uterus with a history of cesarean section.Selected 100 cases of pregnant women with scar uterus re-pregnancy and performed cesarean section as the observation group,and then selected 100 primiparas who received cesarean section during the same period as the control group.Transperineal pelvic floor ultrasound was used to evaluate and compare the pelvic organ movement parameters,levator ani muscle thickness,pelvic diaphragm hiatus parameters and muscle strength of the two groups from resting state to Valsalva state.The moving distance of bladder neck,external cervical orifice and rectum ampulla from resting state to Valsalva state in the observation group were all greater than those in the control group(P<0.05).In the resting state,Valsalva state,and retraction state,the thickness of the levator ani muscle of the observation group was smaller than that of the control group,and the transverse diameter of the pelvic hiatus,the anterior-posterior diameter of the pelvic fissure,and the area of the pelvic hiatus were larger than those of the control group(P<0.05).The surface electrical signals of pelvic floor muscle type I muscle fibers and type II muscle fibers in the observation group were lower than those in the control group,and the proportion of patients with abnormal vaginal pressure and pelvic floor muscle strength in the observation group was greater than that in the control group(P<0.05).Two weeks postpartum,the modified Oxford scale(MOS)pelvic floor muscle strength classification of the observation group was lower than that of the control group as a whole(P<0.05).The pelvic floor structure,pelvic floor function and muscle strength of the scarred uterus with a history of cesarean section are more serious than those of the first cesarean section,and postpartum rehabilitation should be strengthened for this group of people.
作者
闫金玲
刘永莉
焦瑞芳
赵丽芹
YAN Jinling;LIU Yongli;JIAO Ruifang;ZHAO Liqin(Second Department of Obstetrics and Gynaecology,The Fourth Hospital of Shijiazhuang,Shijiazhuang 050000,Hebei,P.R.China)
出处
《影像科学与光化学》
CAS
北大核心
2022年第6期1486-1490,共5页
Imaging Science and Photochemistry
基金
石家庄市科学技术研究与发展计划项目(191460703)。
关键词
剖宫产
瘢痕子宫
妊娠
盆底结构
盆底功能
盆底肌肌力
cesarean section
scarred uterus
pregnancy
pelvic floor structure
pelvic floor function
pelvic floor muscle strength
