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目的探讨三维超声在评估产后女性盆底康复治疗前、后盆膈裂孔变化中的作用。方法产后行盆底康复治疗产妇76例,依据分娩方式分为剖宫产组40例,经阴道分娩组36例,分别于产后42d(治疗前)及盆底康复治疗3个疗程后(治疗后)行经会阴盆底三维超声检查,测量静息状态及Valsalva运动状态下盆膈裂孔前后径、左右径,计算盆膈裂孔面积,并进行比较。结果治疗前剖宫产组静息状态及Valsalva运动状态下盆膈裂孔前后径[(4.83±0.64)、(5.01±0.74)cm]、左右径[(4.14±0.44)、(4.53±0.64)cm]及盆膈裂孔面积[(13.41±2.33)、(16.09±4.81)cm~2]均低于阴道分娩组[前后径(5.12±0.56)、(5.46±0.87)cm,左右径(4.39±0.42)、(4.87±0.69)cm,盆膈裂孔面积(15.07±2.25)、(19.34±5.74)cm~2],差异均有统计学意义(P<0.05);治疗后,剖宫产组静息状态及Valsalva运动状态下、以及阴道分娩组静息状态下盆膈裂孔前后径、左右径、盆膈裂孔面积与治疗前比较差异均无统计学意义(P>0.05),阴道分娩组Valsalva运动状态下盆膈裂孔前后径[(5.02±0.57)cm]、面积[(16.90±3.46)cm~2]低于治疗前(P<0.05),左右径与治疗前比较差异无统计学意义(P>0.05)。结论经阴道分娩产妇产后盆底康复治疗3个疗程后盆底肌恢复情况优于剖宫产产妇,经会阴盆底三维超声有助于初步评估、随访盆底康复治疗效果。
Objective To investigate the role of three-dimensional ultrasonography in assessing changes of diaphragm diaphragm holes before and after pelvic floor rehabilitation in postpartum women. Methods The postpartum pelvic floor rehabilitation was performed in 76 cases. According to mode of delivery, 40 cases were divided into cesarean section group and 36 cases by vaginal delivery group. After postpartum 42d (before treatment) and pelvic floor rehabilitation (after treatment) ) Through the perineal pelvic floor by three-dimensional ultrasound examination, measuring the resting state and Valsalva motion state of the diaphragm diaphragm before and after the diameter, left and right diameter, calculate the diaphragm diaphragm hole area, and compared. Results Before cessation of treatment, the anteroposterior diameter of diaphragmatic foramen in Valsalva exercise group was (4.83 ± 0.64), (5.01 ± 0.74) cm, the diameter of left and right was (4.14 ± 0.44) and (4.53 ± 0.64) cm ] And diaphragmatic hiatus [(13.41 ± 2.33), (16.09 ± 4.81) cm ~ 2] were significantly lower than those of the vaginal delivery group [anteroposterior diameter (5.12 ± 0.56), (5.46 ± 0.87) cm, ), (4.87 ± 0.69) cm, and the area of diaphragm diaphragm hole (15.07 ± 2.25) and (19.34 ± 5.74) cm ~ 2 respectively. There was significant difference between the two groups (P <0.05) There was no significant difference in the anteroposterior diameter, left and right diameter, and diaphragmatic hiatus between the vaginal delivery group and Valsalva during vaginal delivery group (P> 0.05). The Valsalva motility status of vaginal delivery group The anteroposterior diameter of diaphragmatic foramina was (5.02 ± 0.57) cm and the area was (16.90 ± 3.46) cm ~ 2 lower than that before treatment (P <0.05). There was no significant difference between the left and right diameter and the diameter before treatment (P> 0.05). Conclusion The recovery of pelvic floor muscle after vaginal delivery maternal postpartum pelvic floor rehabilitation is better than that of cesarean section. The three-dimensional ultrasound of pelvic floor helps to evaluate the initial pelvic floor healing.