摘要
目的通过三维盆底超声监测肛提肌裂孔形态,评估传统阴道分娩与镇痛分娩对盆底功能的影响。方法选取2021年5月至2022年5月在本院行阴道分娩的初产妇124例,随机分为对照组和观察组,各62例,对照组行传统阴道分娩,观察组行镇痛分娩,比较两组的第二产程时间、出血量,比较两组产前及产后肛提肌裂孔的三维超声参数。结果观察组第二产程时间为(58.90±4.63)min,较对照组的(65.33±4.19)min更短(P<0.05),两组的产时出血量分别为(270.98±34.90)m L、(276.09±33.11)m L,比较无统计学差异(P>0.05)。产后6周,两组产妇静息状态下肛提肌裂孔前后径、左右径均较产前上升(P<0.05),但观察组上述指标均小于对照组(P<0.05)。产后6周,观察组静息、肛提肌收缩以及Valsalva动作下肛提肌裂孔面积均小于对照组(P<0.05)。观察组产妇的Ⅰ、Ⅱ类肌纤维异常、疲劳度异常以及阴道内动态压力异常发生率分别为25.81%、20.97%、29.03%、29.0%,均较对照组的43.55%、38.71%、46.77%、48.39%更低(P<0.05)。结论镇痛分娩可保护初产妇产后盆底功能,三维盆底超声能够为自然分娩产妇产后盆底功能检查提供可靠的影像学依据。
Objective To evaluate the effect of traditional vaginal delivery and analgesic delivery on pelvic floor function by monitoring levator ANI hiatus morphology with three-dimensional pelvic floor ultrasound.Methods A total of 124 puerperae who underwent vaginal delivery of primipara in our hospital from May 2021 to May 2022 were selected and randomy divided into control group and observation group,with 62 case in each group,The control group received traditional vaginal delivery,while the observation group received analgesic delivery.The second stage of labor time and blood loss were compaared between the two groups,a and the three-dimensioal ultrasound parameters of levator ANI hiatus were compared between the two groups.Results The second stage of labor time of the observation group was(58.90±4.63)min,which was shorter than that of the control group(65.33±4.19)min(P<0.05).The intrapartum blood loss of the two groups was(270.98±34.90)ml and(276.09±33.11)ml,and there was no significant difference(P>0.05).At 6 weeks after delivery,the anterior-posterior diameter and left-right diameter of levator ANI hiatus in the resting state of the two groups were higher than those before delivery(P<0.05),but the above indexes in the observation group were lower than those in the control group(P<0.05).At 6 weeks postpartum,the levator muscle hiatus area in the observation group was smaller than that in the control group under resting,levator muscle contraction and Valsalva action(P<0.05).In the observation group,the incidence of typeⅠ、Ⅱmuscle fiber abnormalities,fatigue abnormalities and vaginal dynamic pressure abnormalities were 25.81%,20.97%,29.03%,29.0%,respectively,which were lower than those in the control group(43.55%,38.71%,46.77%,48.39%)(P<0.05).Conclusion Analgesic delivery can protect puerperal pelvicfloor function,and three-dimensional pelvic floor ultrasound can provide reliable imaging basis for the postpartum pelvic floor function examination of puerperae in natural labor.
作者
徐双
Xu Shuang(Ultrasound Medicine Department of Nanyang First People's Hospital,Nanyang 473000,Henan Province,China)
出处
《罕少疾病杂志》
2023年第8期75-77,共3页
Journal of Rare and Uncommon Diseases
关键词
盆底三维超声技术
阴道分娩
分娩镇痛
盆底功能
肛提肌裂孔
Three-dimensional Ultrasound of the Pelvic Floor
Vaginal Delivery
Labor Analgesia
Pelvic Floor Function
Levator Hiatus
