产后盆底结构改变及康复治疗效果的超声量化评估

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Abstract Objective To investigate the changes of pelvic floor structure in postpartum women through the perineal ultrasound,evaluate the effect of rehabilitation therapy,and provide an intuitive and reliable imaging basis for the prevention and treatment of pelvic floor dysfunction caused by delivery.Methods From January 2013 to December 2015,60 primiparas who underwent natural delivery in our hospital were selected as the experimental group,the experimental group was randomly divided into the rehabilitation treatment group (30 cases) and the conventional treatment group (30 cases),and 30 asymptomatic and nulliparous women at the same time were selected as the control group.The rehabilitation treatment group received a course of pelvic floor muscle training,and the conventional treatment group received routine education and natural recovery.The perineal ultrasound was examined at rest and tension,respectively.Ultrasound data were obtained for the experimental group at 6 and 14 weeks after delivery and nulliparous women: bladder neck position (BN),cervical position (CX),and rectal ampulla position (RA),length of the muscular part of the ani levator muscle plane (LAL),to calculate the displacement of the bladder neck,cervix,rectum ampulla from rest period to tension period (bladder neck descent [BND],cervical descent [CXD],rectal ampulla descent [RAD]) and levator ani strain rate (LAS).Results The BND,CXD and LAS of the experimental group were higher than those of the control group,and the differences were statistically significant(P＜0.05).There was no significant difference in RAD between the control group and the experimental group (P＞0.05).The BND,CXD and LAS in the rehabilitation treatment group were lower than those in the conventional treatment group,and the differences were statistically significant (P＜0.05).There was no significant difference in RAD between the rehabilitation treatment group and the conventional treatment group (P＞0.05).Conclusion Pregnancy and delivery may lead to increased mobility of the anterior and middle chamber,represented by the bladder neck and cervix,and LAS,no significant changes in posterior chamber mobility.Pelvic floor rehabilitation treatment has significant effect on postpartum pelvic floor recovery.

Key words： Ultrasound Pelvic floor structural changes Rehabilitation therapy

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