目的 经会阴盆底三维超声动态观察压力性尿失禁初产妇盆膈裂孔的结构改变.方法 选取2015年1月至2017年6月在我院妇产科定期行产后复查的女性118例(产后组),其中有压力性尿失禁(Stress Urinary Incontinence,SUI)症状46例(SUI产妇),无SUI症状72例(非SUI产妇),同期选取未育的无漏尿便秘症状健康妇女60例(对照组).测量Valsalva动作后的膀胱颈移动度,比较各组妇女在静息状态、缩肛动作和Valsalva动作3种状态下的盆膈裂孔面积及周长.结果 产后组妇女Valsalva动作下的膀胱颈移动度明显大于对照组妇女,在静息状态、缩肛动作及Valsalva动作3种状态下,产后组妇女的盆膈裂孔面积及周长均明显大于对照组妇女.SUI产妇Valsalva动作下的膀胱颈移动度明显大于非SUI产妇,SUI产妇在3种状态下的盆膈裂孔面积及周长均明显大于非SUI产妇.结论 经会阴三维超声动态检查能有效观察产后女性尤其SUI产妇盆膈裂孔的解剖结构与功能的变化.%Objective To study the correlation of morphological and functional characteristics of pelvic diaphragm hiatus in postpartum women with stress urinaryincontinence (SUI) by transperineal three-dimensional ultrasonography. Methods From January 2015 to June 2017, 118 postpartum women underwent transperineal 3D ultrasound investigation, including 46 postpartum women with SUI and the other 72 postpartum women without SUI. In the mean time, 60 normal nulliparous healthy women without SUI and constipation were chosen as control group. The perimeter and area of pelvic diaphragm hiatus were measured at rest, on maximum pelvic floor contraction and maximum Valsalva by 3D ultrasound, respectively. The mobility of urethrovesical junction was measured on maximum Valsalva. Results The perimeter and area of pelvic diaphragm hiatus were significantly increased than those in control group, at rest, on maximum pelvic floor contraction and maximum Valsalva respectively. While the mobility of urethrovesical junction (URJ) was higher than that in control group on maximum Valsalva. The perimeter and area of pelvic diaphragm hiatus in postpartum women with SUI were increased than those without SUI at three maneuvers, respectively, the mobility of URJ was higher than that without SUI on maximum Valsalva. Conclusion Transperineal three-dimensional ultrasonography has great value for pelvic diaphragm hiatus change in postpartum women ,especially those with SUI.
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