三维超声和盆底肌电生理评估联合评价产后早期肛提肌收缩功能
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摘要
目的 :探讨三维超声和盆底肌电生理评估联合评价产后早期肛提肌收缩功能的应用价值。方法 :选取2016年3月—2018年3月我院进行产后6～8周复查无盆底功能障碍的初产妇60例,按1∶1的比例随机抽取顺产组30例,剖宫产组30例,同期选取无生育流产史的健康妇女30例为对照组。所有入选对象均进行三维超声检查及盆底肌电生理评估,比较三组之间的差异,分析缩肛期盆膈裂孔大小的相对变化量与盆底肌电值之间的相关性。结果:缩肛期盆膈裂孔大小相对变化量与盆底表面肌电值呈正相关,相关系数0.37～0.68。结论:三维盆底超声检查和盆底肌电生理评估对肛提肌收缩功能的评价具有重要意义。
Objective: To evaluate the application value of the levator ani contraction function in early postpartum women by using the three-dimensional ultrasound and pelvic floor muscle electrophysiological assessment. Methods: A total of 60 primiparas without pelvic floor dysfunction who review in postpartum 6 ～8 weeks were selected as study objects in Xuzhou Maternity and Child Health Care Hospital from March 2016 to March 2018, and then they were divided into natural delivery group 30 cases, and cesarean section group 30 cases, randomly according the ratio 1∶1. Meanwhile, cases of 30 healthy nulliparas were chosen as control group during the same period. The three-dimensional ultrasound and pelvic floor muscle electro-physiological assessment were performed in the three groups. The differences between the three groups were compared, and the correlations between the relative variation quantity of pelvic diaphragm hiatus under anus contracting condition and pelvic floor electrophysiological parameters were analyzed. Results: The relative variation quantity of pelvic diaphragm hiatus under anus contracting condition were positively correlated to pelvic floor electrophysiological parameters, and the correlation coefficient was 0.37～0.68. Conclusion: The three-dimensional ultrasound and pelvic floor muscle electrophysiological assessment have sig-nificances in evaluation on the levator ani contraction function.
Objective: To evaluate the application value of the levator ani contraction function in early postpartum women by using the three-dimensional ultrasound and pelvic floor muscle electrophysiological assessment. Methods: A total of 60 primiparas without pelvic floor dysfunction who review in postpartum 6 ～8 weeks were selected as study objects in Xuzhou Maternity and Child Health Care Hospital from March 2016 to March 2018, and then they were divided into natural delivery group 30 cases, and cesarean section group 30 cases, randomly according the ratio 1∶1. Meanwhile, cases of 30 healthy nulliparas were chosen as control group during the same period. The three-dimensional ultrasound and pelvic floor muscle electro-physiological assessment were performed in the three groups. The differences between the three groups were compared, and the correlations between the relative variation quantity of pelvic diaphragm hiatus under anus contracting condition and pelvic floor electrophysiological parameters were analyzed. Results: The relative variation quantity of pelvic diaphragm hiatus under anus contracting condition were positively correlated to pelvic floor electrophysiological parameters, and the correlation coefficient was 0.37～0.68. Conclusion: The three-dimensional ultrasound and pelvic floor muscle electrophysiological assessment have sig-nificances in evaluation on the levator ani contraction function.
引文
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[10]Bo K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength[J]. Phys Ther, 2005, 85(3):269-282.
[11]Thyer I, Shek C, Dietz HP. New imaging method for assessing pelvic floor biomechanics[J]. Ultrasound Obstet Gynecol, 2008,31(2):201-205.
[12]Resende AP, Petricelli CD, Bemardes BT, et al. Electromyographic evaluation of pelvic floor muscles in pregnant and nonpregant women[J]. Int Urogynecol J, 2012, 23(8):1041-1045.
[13]陶均佳,徐莲,刘菲菲,等.三维超声评估产后盆底肌收缩功能的初步研究[J].中国超声医学杂志,2013,29(5):440-443.
[14]申志茜,任保辉,陈凤霞,等.生物反馈联合电刺激治疗女性压力性尿失禁的临床观察[J].中国妇产科临床杂志,2016,17(5):444-445.
[2]陈瑞云,宋岩峰,江丽,等.肛提肌收缩功能的三维超声评估[J].实用妇产科杂志,2010,26(9):671-673.
[3]Delancey JO, Kearney R, Chou Q, et al. The appearance of levator ani muscle abnormalities in magnetic resonance images after vaginal delivery[J]. Obstet Gynecol, 2003, 101(1):46-53.
[4]王毅,龚水根,张伟国,等. MRI对分娩并发肛提肌损伤的评价研究[J].中华放射学杂志,2006,40(10):1075-1078.
[5]张曼,王荣,王兴田,等.三维超声评估女性盆膈裂孔的研究[J].中国临床医学影像杂志,2015,26(9):657-659.
[6]李勤,应涛,徐莲.妊娠晚期女性盆膈裂孔的超声影像学表现[J].中华超声影像学杂志,2012,21(6):496-499.
[7]王慧芳,陈华,折瑞莲,等.经会阴超声评估前盆腔器官脱垂程度与临床盆腔器官脱垂定量分期的相关性研究[J].中华超声影像学杂志,2013,22(8):684-687.
[8]许瑶璇,张丽,袁秀珍,等.断层超声评估肛提肌肌力的可行性探讨[J].中国医药导报,2016,13(28):111-115.
[9]白云,刘菲菲,李勤,等.产后不同时期女性肛提肌收缩功能的超声评价[J].中华超声影像学杂志,2015,24(7):597-599.
[10]Bo K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength[J]. Phys Ther, 2005, 85(3):269-282.
[11]Thyer I, Shek C, Dietz HP. New imaging method for assessing pelvic floor biomechanics[J]. Ultrasound Obstet Gynecol, 2008,31(2):201-205.
[12]Resende AP, Petricelli CD, Bemardes BT, et al. Electromyographic evaluation of pelvic floor muscles in pregnant and nonpregant women[J]. Int Urogynecol J, 2012, 23(8):1041-1045.
[13]陶均佳,徐莲,刘菲菲,等.三维超声评估产后盆底肌收缩功能的初步研究[J].中国超声医学杂志,2013,29(5):440-443.
[14]申志茜,任保辉,陈凤霞,等.生物反馈联合电刺激治疗女性压力性尿失禁的临床观察[J].中国妇产科临床杂志,2016,17(5):444-445.