| 摘要: |
| 【】 目的 用经会阴三维超声观察产钳助产对女性肛提肌和肛门括约肌损伤的影响。方法 2016年7月至2017年11月在首都医科大学附属北京妇产医院超声科就诊的61例产钳助产术后患者作为研究组,60例同时期正常经阴道分娩患者作为对照组。对两组妇女经会阴超声容积数据进行回顾性分析,比较肛提肌和肛门括约肌损伤发生率。结果 两组孕产史、产时平均年龄、BMI、胎儿平均出生体重、产后超声检查时间等均无明显差异(P＞0.05)。研究组和对照组肛提肌撕裂发生率为45.90%及8.33%,有统计学差异(P＜0.01)；肛提肌裂孔发生率分别为40.98%及43.33%,无明显差异(P＞0.05)。研究组中22.95%妇女发现有肛门括约肌损伤,而对照组中肛门括约肌损伤发生率为8.33%,两组比较有统计学差异(P＜0.05)。结论 产钳助产术后产妇肛提肌撕裂和肛门括约肌损伤发生率高,临床中应关注产钳导致的盆底损伤。 |
| 关键词: 三维超声 经会阴 肛提肌 肛门括约肌 损伤 产钳 |
| DOI： |
| 投稿时间：2017-11-21修订日期：2017-11-21 |
| 基金项目:北京市医院管理“登峰”计划专项经费资助（DFL20151302） |
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| Study on the impact of forceps assisted delivery on the levator ani muscle and anal sphincter injuries by 3D transperineal ultrasound |
| Xuan Ying-hua,Wu Qing-qing |
| (Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University) |
| Abstract: |
| Objectives To observe the impact of forceps assisted delivery on the levator ani muscle and anal sphincter injuries using 3D transperineal ultrasound.。Methods Retrospectively analyzed the volume data of the 61 women with forceps assisted delivery as study group and 60 women with normal vaginal delivery as control group. All the women underwent transperineal ultrasound examination in Beijing Obstetrics and Gynecology Hospital from July 2016 to November 2017. The incidence of levator ani injury and anal sphincter injury was compared. Results The parity history, mean age, BMI, fetal weight at birth and the duration after delivery of study group and control group had no difference(P＞0.05). The incidence of levator ani avulsion of study group and control group were 45.90% and 8.33%, which was significantly different(P＜0.01), whereas the incidence of ballooning of levator ani of both group were 40.98% and 43.33% respectively, showing no difference(P＞0.05). Anal sphincter injury was found in 22.95% women in study group and 8.33% women of control group, which is statistically significant(P＜0.05). Conclusions The incidence of levator ani avulsion and anal sphincter injuries were elevated significantly in the women with history of forceps assisted delivery. The pelvic muscle injuries caused by forceps should receive more intensive attention in clinical practice. |
| Key words: 3D ultrasound transperineal levator ani muscle anal sphincter injury forceps |
