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目的采用会阴四维超声评估不同分娩方式对产后女性盆膈裂孔的影响。方法选取2015年7月-2017年1月在湖南省妇幼保健院分娩的86例产妇,其中自然分娩46例、剖宫产40例;同时选取无生育流产史妇女45例作为对照,采用会阴四维超声评价女性盆膈裂孔形态。结果静息状态和Valsalva动作下,自然分娩组、剖宫产组和对照组盆膈裂孔左右径、前后径和面积比较,差异无统计学意义(P>0.05);缩肛动作下,自然分娩组盆膈裂孔左右径、前后径和面积分别为(3.81±0.48)cm、(4.27±0.53)cm和(12.08±2.06)cm~2,明显高于对照组和剖宫产组(P>0.05);缩肛动作下,剖宫产组和对照组盆膈裂孔左右径、前后径和面积比较差异无统计学意义(P>0.05)。结论经会阴四维超声可清晰观察盆底结构,在缩肛动作时阴道分娩产妇盆膈裂孔增加明显,静息及Valsalva动作下盆膈裂孔与分娩方式无明显关系。
Objective To evaluate the effect of different modes of delivery on pelvic diaphragm perforation in postpartum women by using four-dimensional perineal ultrasound. Methods From July 2015 to January 2017, 86 maternal births were given at Hunan Provincial Maternal and Child Health Hospital, among which 46 were delivered spontaneously and 40 were cesarean. 45 women with no abortion history were selected as controls. Ultrasound evaluation of female diaphragm diaphragm hole morphology. Results There was no significant difference in left and right diameter, anteroposterior diameter and area of phrenic foramen in spontaneous delivery group, cesarean section group and control group at rest and Valsalva (P> 0.05) The diameter, anteroposterior diameter and area of diaphragmatic foramina were (3.81 ± 0.48) cm, (4.27 ± 0.53) cm and (12.08 ± 2.06) cm ~ 2, respectively, which were significantly higher than those in control group and cesarean section group There was no significant difference in left and right diameter, anteroposterior diameter and area between the cesarean section group and the control group in the anal femoris operation (P> 0.05). Conclusions The pelvic floor structure can be clearly observed through the four-dimensional ultrasound of the perineum. The pelvic diaphragm hole of the vaginal childbirth increased significantly when the anus was operated, and there was no significant relationship between the septum diaphragm and the mode of delivery under resting and Valsalva motions.