葉敏歡 方建華 鄭穗瑾 陳莞春 方潤儀 文先妹


[摘要] 目的 探討經會陰四維超聲在經產婦盆底康復治療中評估應用價值。 方法 方便選取2018年1—12月該院診治盆底功能障礙經產婦80例進行研究,用隨機分組表法分為實驗組(電刺激聯合生物反饋康復治療)和對照組(自然恢復)各40例,兩組患者在產后第6周及產后第12周分別進行經會陰四維超聲檢查,比較治療前后患者在平靜呼吸和Valsalva動作時肛提肌厚度、膀胱頸移動度、膀胱尿道后角、盆膈裂孔面積。結果 治療后膀胱頸移動度、膀胱尿道后角、盆膈裂孔面積實驗組在平靜呼吸下分別是:(2.11±0.35)cm、(122.4±21.1)°、(13.2±1.3)cm2,明顯低于對照組,差異有統計學意義(t=0.629、2.552、3.703,P<0.05)在Valsalva動作下分別是(2.19±0.38)cm、(137.6±31.5)°、(23.3±3.6)cm2,明顯低于對照組,差異有統計學意義(t=0.116、2.022、4.647,P<0.05)。結論 經會陰四維超聲在經產婦盆底康復治療中應用,能有效反映患者盆底康復治療效果。
[關鍵詞] 四維超聲;經產婦;盆底康復;電刺激;生物反饋
[中圖分類號] R828.2,R445.1? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742(2020)02(b)-0189-03
Clinical Application of Transperineal Four-dimensional Ultrasound in Pelvic Floor Rehabilitation of Midwives
YE Min-huan1, FANG Jian-hua2, ZHENG Sui-jin1, CHEN Guan-chun2, FANG Run-yi1, WEN Xian-mei2
1.Department of Obstetrics, HouJie Hospital,Dongguan,Guangdong Province,523945 China;2.Department of Ultrasound, Houjie Hospital, Dongguan, Guangdong Province, 523945 China
[Abstract] Objective To explore the application value of transperineal four-dimensional ultrasound in the pelvic floor rehabilitation treatment of postpartum women. Methods 80 cases of transvaginal women with pelvic floor dysfunction treated in the hospital from January 2018 to December 2018 were conveniently selected for the study. They were randomLy divided into experimental group (electrical stimulation combined with biofeedback rehabilitation therapy) and control group (natural recovery), 40 cases in each group. Four-dimensional transperineal ultrasonography was performed in the 6th week and 12th week of postpartum respectively. The levator ani muscle thickness, bladder neck mobility, posterior horn of bladder and urethra, and pelvic diaphragm hole area were compared before and after treatment. Results After treatment, the bladder neck mobility, the posterior horn of bladder urethra and the area of pelvic diaphragm hole in the experimental group were (2.11±0.35)cm,(122.4±21.1)°,(13.2±1.3)cm2 under quiet breathing, which were significantly lower than those in the control group,the difference was statistically significant(t=0.629, 2.552, 3.703, P<0.05) and were (2.19±0.38)cm,(137.6±31.5)°,(23.3±3.6)cm2, respectively, which were significantly lower than those in the Valsalva group. The control group,the difference was statistically significant(t=0.116, 2.022, 4.647, P<0.05). Conclusion The application of transperineal four-dimensional ultrasound in the treatment of pelvic floor rehabilitation of postpartum women can effectively reflect the therapeutic effect of pelvic floor rehabilitation.
綜上所述,經會陰四維超聲在經產婦盆底康復治療中應用,能有效反映患者盆底康復治療效果。
[參考文獻]
[1]? 阮飛娜,楊俊娟,郭華峰,等.經會陰超聲評價康復治療對壓力性尿失禁患者盆底功能和結構的影響[J].中國計劃生育學雜志,2018,26(11):1111-1114.
[2]? 張偉,朱亞,向雙,等.產后女性盆底康復治療后盆膈裂孔的三維超聲評估[J].中華實用診斷與治療雜志,2016,30(8):808-810.
[3]? 劉文聰,張鵬,李海燕,等.超聲評價不同分娩方式對盆底結構和功能的影響及康復治療的效果[J].河北醫科大學學報,2018,39(10):1193-1196,1200.
[4]? 李世瓊,劉麗娜,勾青,等.盆底康復技術對產后盆底功能障礙的防治作用[J].海南醫學院學報,2017,23(4):546-548, 552.
[5]? Pastore AL,Palleschi G,Fuschi A,et al. Pelvic muscle floor rehabilitation as a therapeutic option in lifelong premature ejaculation: long-term outcomes[J].Asian J Androl,2018,12(6):572-575.
[6]? 張美琴,楊帆,宋清蕓,等.產后早期壓力性尿失禁的三維盆底超聲表現[J].中國醫學影像學雜志,2017,25(12):929-932.
[7]? 古艷,林梅清.經會陰超聲評估肌電刺激盆底治療壓力性尿失禁的療效[J].放射學實踐,2016,31(10):1006-1009.
[8]? 許源城,楊飛,李文標,等.經會陰實時三維超聲在女性壓力性尿失禁患者中的應用[J].廣東醫學,2017,38(18):2778-2781.
(收稿日期:2019-11-16)
[基金項目] 東莞市社會科技發展(一般)項目(201850715023 1390)。
[作者簡介] 葉敏歡(1982-),女,廣東佛山人,本科,副主任醫師,研究方向:婦產科。