实时三维超声观察不同分娩方式对产后压力性尿失禁的影响

摘要

Objective:To investigate the effect of different delivery modes on stress urinary incontinence by transperineal three-dimensional ultrasound.Method:The author to,312 patients of urinary incontinence were selected and diagnosed in our hospital,the treatment-related data was analyzed.The patients were divided into two groups depending on the mode of delivery, the control group of 150 cases were treated by vaginal delivery,the experimental group of 162 cases were treated by caesarean section.The patients were used transperineal three-dimensional ultrasound examination,the impact of different delivery methods for postpartum stress urinary incontinence were analyzed. Result:The experimental group BND was (2.32±0.56)cm, levator hiatus during quiet area was (15.2±1.9)cm2, the maximum Valsalva maneuver levator hiatus area was (20.1±4.5)cm2, lower than the control group BND of (2.61±0.49)cm,levator hiatus during quiet area of (17.3±2.0)cm2, the maximum Valsalva maneuver levator hiatus area of (22.3±3.9)cm2,the difference was statistically significant(P<0.05).The experimental group after 6 months postpartum voiding status score were (2.53±0.44)points, urination after 12 months postpartum condition score were (1.86±0.33)points,lower than that in the control group;the experimental group 6 months postpartum pelvic floor muscle strength score for (3.18±0.43) points, after 12 months postpartum pelvic floor muscle strength score of (4.46±0.42) points,higher than the control group, the difference was statistically significant(P<0.05). Conclusion:The prevalence of stress urinary incontinence is higher,using the transperineal three-dimensional ultrasound to observe SUI, the effect is ideal and different ways of delivery has impact for SUI.%目的：探讨经会阴三维超声观察不同分娩方式对压力性尿失禁（SUI）的影响。方法：对来笔者医院诊断、治疗的312例尿失禁患者相关资料进行分析，根据患者不同分娩方式将其分为两组，对照组150例实施阴道分娩，试验组162例实施剖宫产，采用会阴三维超声对患者进行检查，分析不同分娩方式对产后压力性尿失禁的影响。结果：试验组BND为（2.32±0.56）cm，安静时肛提肌裂孔面积为（15.2±1.9）cm2，最大Valsalva动作时肛提肌裂孔面积为（20.1±4.5）cm2，对照组BND为（2.61±0.49）cm，安静时肛提肌裂孔面积为（17.3±2.0）cm2，最大Valsalva动作时肛提肌裂孔面积为（22.3±3.9）cm2，两组比较差异均有统计学意义（P<0.05）；试验组产后6个月排尿状况评分为（2.53±0.44）分、产后12个月排尿状况评分为（1.86±0.33）分，均低于对照组；试验组产后6个月盆底肌力评分为（3.18±0.43）分，产后12个月盆底肌力评分为（4.46±0.42）分，高于对照组，两组比较差异有统计学意义（P<0.05）。结论：压力性尿失禁发病率较高，临床上采用经会阴三维超声观察SUI，效果理想且不同分娩方式对SUI的影响有差别。