摘要
目的探讨经会阴三维盆底超声联合实时剪切波弹性成像(SWE)对初产妇产后盆底功能的评估价值。方法采用前瞻性队列研究方法,选择2020年1月至2022年1月于信阳市中医院进行产后复查的113例初产妇,所有产妇均进行经会阴三维盆底超声及SWE检查并记录检查结果;依据产妇体格检查、盆腔器官脱垂分期评估、压力诱发试验、棉签试验等临床综合指标检查结果将其分为盆底功能障碍组及盆底功能正常组,比较两组一般资料及超声检查参数,绘制受试者工作曲线(ROC)评价经会阴三维盆底超声联合SWE对初产妇产后盆底功能的评估价值。结果产后复查时,113例初产妇中出现盆底功能障碍67例,占59.29%;与盆底功能正常组相比,盆底功能障碍组静息及最大缩肛状态下肛提肌裂孔左右径(LHLD)、前后径(LHAP)、面积(LHA)值均较大(P<0.05);与盆底功能正常组相比,盆底功能障碍组静息及最大缩肛状态下耻骨直肠肌的杨氏模量平均值均较小(P<0.05);ROC曲线显示,LHLD、LHAP评估初产妇产后盆底功能的AUC分别为0.630、0.593,评估价值较低,LHA及杨氏模量平均值单独及两种检查方法联合评估初产妇产后盆底功能的AUC分别为0.785、0.744、0.891,均有一定评估价值,且联合评估价值更高。结论经会阴三维盆底超声联合SWE对初产妇产后盆底功能具有一定评估价值。
Objective To explore the value of transperineal three-dimensional pelvic floor ultrasound combined with real-time shear wave elastography(SWE)in the evaluation of pelvic floor function in primiparas.Methods A prospective cohort study was conducted to select 113 primiparas who underwent postpartum reexamination in Xinyang Hospital of Traditional Chinese Medicine from January 2020 to January 2022.All primiparas underwent perineal three-dimensional pelvic floor ultrasound and SWE,and the examination results were recorded.According to the results of maternal physical examination,pelvic organ prolapse staging evaluation,pressure induction test,cotton swab test and other clinical comprehensive indicators,they were divided into pelvic floor dysfunction group and pelvic floor function normal group.The general data and ultrasonic examination parameters of the two groups were compared,and the receiver operating curve(ROC)was drawn to evaluate the value of transperineal three-dimensional pelvic floor ultrasound combined with SWE in the evaluation of pelvic floor function after primipara.Results During postpartum reexamination,there were 67 patients had pelvic floor dysfunction in 113 primiparas,accounting for 59.29%.Compared with the group with normal pelvic floor function,levator hiatal anteroposterior diameter(LHAP),levator hiatal lateral diameter(LHLD)、levator hiatal area(LHA)in the group with pelvic floor dysfunction were larger at rest and in the state of maximum anal constriction(P<0.05).Compared with the group with normal pelvic floor function,the average Young’s modulus of puborectal muscle in the group with pelvic floor dysfunction at rest and maximum anal constriction was smaller(P<0.05).The ROC curve showed that the AUC of LHLD and LHAP in evaluating the postpartum pelvic floor function of primiparas were 0.630 and 0.593 respectively,which was of low evaluation value.The AUC of LHA and Young’s modulus in evaluating the postpartum pelvic floor function of primiparas alone and in combination with the two exam
作者
张侠
ZHANG Xia(Department of Ultrasound,Xinyang Hospital of Traditional Chinese Medicine,Xinyang 464000,China)
出处
《河南医学研究》
CAS
2023年第6期1047-1051,共5页
Henan Medical Research
关键词
初产妇
盆底功能
三维超声
实时剪切波弹性成像
primipara
pelvic floor function
three dimensional ultrasound
real time shear wave elastography
