中国全科医学2017，Vol.20Issue(27)：3443-3447,5.DOI:10.3969/j.issn.1007-9572.2017.05.y10
首次分娩女性产后6~8周盆底超声检查分析
Value of Pelvic Floor Ultrasound in Primiparas in 6-8 Weeks after Delivery
摘要
Abstract
Objective To investigate the value of pelvic floor ultrasound in primiparas in 6~8 weeks after delivery.Methods From May 2014 to August 2016,pelvic floor ultrasound was performed in 335 consecutive primiparas who visited the Outpatient Department of the Third Affiliated Hospital,Sun Yat-sen University in 6-8 weeks after delivery.The bladder neck position,and bladder neck mobility,retrovesical angle,urethral rotation angle,area of levator hiatus and cervical perigee were assessed at rest and maximum Valsalva maneuver,and the ultrasound findings were summarized.According to the criterion of bladder bulging, they were divided into normal group, type Ⅰ bladder bulging group, type Ⅱ bladder bulging group and type Ⅲ bladder bulging group.Results Twelve women were excluded from the study because they failed to exhale with maximum effort (Valsalva maneuver),the rest 323 were recruited.The bladdler neck position,retrovesical angle,area of levator hiatus,cervical perigee at rest was(27.8±3.7)mm,(109.5°±20.4°),(14.3±4.8)cm2,(33.6±6.1)mm,respectively,and those during maximum Valsalva maneuver was (5.5±9.3)mm,(133.4°±24.5°),(21.7±5.7)cm2,and (25.4±5.6)mm,respectively.The bladder neck mobility and urethral rotation angle during maximum Valsalva maneuver was (22.7±8.5)mm,and(47.2°±21.7°),respectively.A total of 227 participants had normal ultrasound findings,96 had cystocele.Among the 96 cases,21 had gradeⅠcystocele with the manifestations:the bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation <45° during maximum Valsalva maneuver;57 had grade Ⅱ cystocele with the following manifestations:the bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ≥45° during maximum Valsalva maneuver;18 had grade Ⅲ cystocele with the manifestations:the bladder was lower than inferoposterior margin of the symphysis pubis,cystocele with intact retrovesical angle (<140°) and urethral rotation ≥45° during maximum Valsalva maneuver.There were 18 (5.6%)women with cystocele combined with uterine prolapse,with the presentation of cervical perigee were 15 mm lower than the inferoposterior margin of the symphysis pubis during maximum Valsalva maneuver.The area of levator hiatus in each type of bladder bulging group was larger than that in normal group(P<0.05).Conclusion The pelvic floor ultrasound can correctly evaluate the bladder neck position and mobility,retrovesical angle,the urethral rotation angle,area of levator hiatus and cervical perigee at rest and maximum Valsalva maneuver in primiparas in 6-8 weeks after delivery.It also can be used for grading cystocele in postpartum women,which may provide reliable reference for clinical diagnosis and prevention of organ prolapse.关键词
分娩/超声检查/盆底疾病/产后期/膀胱膨出/子宫脱垂Key words
Parturition/Ultrasonography/Pelvic floor disorders/Postpartum period/Cystocele/Uterine prolapse分类
医药卫生引用本文复制引用
毛永江,武佳薇,张辉,郑荣琴,张新玲..首次分娩女性产后6~8周盆底超声检查分析[J].中国全科医学,2017,20(27):3443-3447,5.基金项目
广东省科技计划项目(2014A020212486) （2014A020212486）
广东省医学科学技术研究基金项目(A2015284) （A2015284）
