| 摘要: |
| 目的 应用高频超声联合剪切波弹性成像（SWE）定量评估产后女性的腹直肌间距、腹直肌硬度及厚度，分析腹直肌分离（DRA）的相关因素。方法 选取于我院门诊进行产后复查的初产妇224例，应用高频超声、SWE获得脐上3 cm、脐水平、脐下3 cm的腹直肌厚度、腹直肌间距、弹性模量（E）及剪切波速度（V），以任一部位腹直肌间距＞2 cm作为诊断DRA的标准将产妇分为DRA组和对照组，比较两组上述参数的差异，二元Logistic回归分析各超声参数与DRA的相关性，绘制受试者工作特征（ROC）曲线分析各参数诊断DRA的效能。结果 DRA组平均腹直肌厚度、E、V分别为7.30±0.67mm、10.85（9.67,12.13）kPa、1.85（1.73,1.97）m/s，对照组分别为7.99±0.56 mm、13.20（12.23,14.04）kPa、2.07（1.97,2.13）m/s，两组比较差异均有统计学意义（均P＜0.01）。二元Logistic回归分析显示，较低的腹直肌厚度、E、V是DRA发生的独立相关因素。ROC曲线分析显示，当E以12.05 kPa为截断值，其诊断DRA的曲线下面积为0.852（95%可信区间：0.803～0.902，P＜0.001）。结论 SWE可定量评估腹直肌硬度，较低的腹直肌硬度和厚度均是DRA发生的独立危险因素，且腹直肌硬度与DRA关系更密切。 |
| 关键词: 相关因素 超声检查 腹直肌分离 硬度 厚度 |
| DOI： |
| 投稿时间：2022-06-24修订日期：2022-12-08 |
| 基金项目:]广州市卫生健康委员会西医类-一般引导项目,穗卫科教[2021]6号20221A010017 |
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| To Study The Related Factors Of Postpartum Diastasis of The Rectus Abdominis Based on High Frequency Ultrasound Combined With Shear Wave Elastography WANG Liang*,HUANG Jun2,WANG Xiaona2 |
| Wangliang |
| () |
| Abstract: |
| Objective High-frequency ultrasound combined with shear wave elastography(SWE) was used to quantitatively evaluate inter-rectus distance, stiffness, and thickness of rectus abdominis, and to analyze the related factors of diastasis rectus abdominis(DRA) in postpartum women. Methods A total of 224 primiparas who underwent postpartum examination in the outpatient department of our hospital were selected. The thickness of rectus abdominis, inter-rectus distance, elastic modulus (E), and shear wave velocity (V) at 3 cm above the umbilicus, umbilicus level, and 3 cm below the umbilicus were obtained by high-frequency ultrasound and SWE. Postpartum women were divided into the DRA group and the control group with inter-rectus distance > 2 cm as diagnosis criterion of DRA. The differences in the ultrasound parameters between the two groups were compared. The correlation between the ultrasonic parameters and DRA was analyzed by binary Logistic regression. Receiving operating characteristic （ROC） curve was drawn to analyze the effectiveness of each parameter in the diagnosis of DRA. Results The mean thickness, E and V of rectus abdominis in the DRA group were 7.30±0.67mm,10.85(9.67,12.13)kPa, and 1.85 (1.73,1.97) m/s, respectively. The mean thickness, E, and V of rectus abdominis in the control group were 7.99±0.56 mm, 13.20 (12.23,14.04) kPa, 2.07 (1.97,2.13) m/s. There were statistically significant differences between the two groups (all P < 0.01). Binary Logistic regression analysis showed that lower thickness, E, and V in the rectus abdominis were independent related factors of DRA. ROC curve analysis showed that when E was 12.05 kPa as the cut-off value, the area under the curve for the diagnosis of DRA was 0.852 (95% confidence interval: 0.803-0.902, P < 0.001). Conclusions The stiffness of the rectus abdominis can be quantitatively evaluated via SWE. Lower stiffness and thickness of rectus abdominis are independent risk factors for DRA, and the stiffness of rectus abdominis is more closely related to DRA. |
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