低位产钳助产术对女性盆底功能的影响

摘要

Objective The purpose of this research is to evaluate the effects of low forceps delivery on female pelvic floor function using 3D/Real-time 3D volume ultrasound,and to investigateits influences on female pelvic floor function disorder.Methods Participants were choosing from patients of our hospital from,including 31 women performing low forceps delivery as patient group and 31 women with matching options during the same time performing normal vaginal delivery as control group.All subjects were examined by 3D/Real-time 3D pelvic ultrasound.Images were collected from two groups of patients respectively at resting,Valsalva and Shrinking anus.Related parameter measurement was residual urine,bladder neck movement,cervical nadir,basin separated hiatal area size and observation of the related parameters of anus levator integrity measurement.Results In the patient group,the incidence rates of increasing residual urine and bladder neck mobile degree and pelvic diaphragm in increase were 3.2％,25.8％ and 38.7％ respectively.There was no statistically significant differences in (P＞0.05) compared with the control group (incidence of 3.2％,19.4％,35.4％ respectively).The incidence rates of uterine prolapse,anal muscle tear were respectively 19.4％,38.7％,which was significantly higher than those the control group (the incidence of 0,9.7％) differences statistically (P=0.010,0.008).Conclusions Low forceps midwifery is a highly risky factor of female pelvic floor dysfunction.Observing the incidence of uterine prolapse and anal muscle tear using 3D/Real-time 3D pelvic ultrasound can be an effective means of evaluating pelvic floor function,so as to timely diagnosis and guiding clinical.%目的 应用三维/实时三维容积超声评估低位产钳助产对女性盆底功能的影响,分析产钳助产在女性盆底功能障碍性疾病发生中的作用.方法 选择我院通过低位产钳助产分娩后女性31例作为病例组,根据入组患者相关因素匹配选择同时期正常阴道分娩产妇31例作为对照组.两组患者均进行三维/实时三维盆底超声检查,分别在静息、Valsalva及提肛三个状态采集图像.进行残余尿、膀胱颈移动度、官颈最低点、盆膈裂孔面积大小及观察肛提肌完整性的相关参数的测量.结果 病例组中残余尿增多、膀胱颈移动度增大、盆膈裂孔增大发生率分别为3.2％、25.8％、38.7％,与对照组(发生率分别为3.2％、19.4％、35.4％)相比差异无统计学意义(P＞0.05).病例组中子宫脱垂、肛提肌不同程度撕裂发生率分别为19.4％、38.7％,明显高于对照组(发生率0、9.7％),差异具有统计学意义(P=0.010、0.008).结论 低位产钳助产是引起女性盆底功能障碍的高危因素,三维/实时三维盆底超声检查观察子宫脱垂、肛提肌撕裂发生率可对盆底功能进行有效评估,从而及时诊断并指导临床.