| Objectives Application by the perineum three-dimensional ultrasound as maternal anal levator Hiatal Area(hiatal area,HA)dynamic change rule and influence factors of quantitative evaluation and application of shear wave elastography technology perineal body dynamic change of young’s modulus value,for the clinical prevention of Pelvic Floor functional disorder(pelvic floor dysfunction,PFD),postpartum rehabilitation and imaging basis for evaluation of curative effect after treatment.Methods From October 2019 to September 2020,80 cases of puerpera in the ultrasound department of Tangshan workers’ hospital were selected as the postpartum follow-up group for pelvic floor ultrasound examination;Another 80 healthy women were selected as the reference control group.The basic data of postpartum follow-up group were collected and divided into cesarean section group and vaginal delivery group according to different delivery methods.The young’s modulus of the perineal body and the area of levator ani hiatus were measured by transperineal elastic ultrasound and three-dimensional ultrasound in three different states(resting state,anal contraction state and Valsalva state);The follow-up time of postpartum follow-up group was 42 days,3 months and 6 months after delivery.The above indexes were measured in the reference control group.Spss23.0statistical software was used to process and analyze the related data.The counting data was expressed by the rate and chi square test was selected;The measurement data obeying normal distribution are expressed with(sx ±)and t-test is applied;Repeated measurement data were analyzed by two-way repeated measurement ANOVA,different groups were compared by independent sample t-test,different follow-up time were compared by oneway repeated measurement ANOVA,and paired sample t-test was used for pairwise comparison in time dimension;All statistical tests were performed by two-sided test,and the test level was high α= 0.05。Results 1 The recovery of perineal body with time: the young’s modulus of perineal body gradually increased from 42 days to 6 months postpartum,showing a recovery trend.The difference between the postpartum follow-up group and the reference control group was statistically significant(P<0.05);2 Levator ani muscle hiatus area recovery with time: 42 days postpartum to 6 months postpartum,levator ani muscle hiatus area gradually decreased,showing a recovery trend,postpartum follow-up group compared with the reference control group,the difference was statistically significant(P<0.05);3 The recovery of perineal body in different delivery modes: during the postpartum follow-up period,the young’s modulus of perineal body in cesarean section group was higher than that in vaginal delivery group,and the difference was statistically significant(P<0.05);4Recovery of levator ani muscle hiatus area in different delivery methods: during the postpartum follow-up period,the area of levator ani muscle hiatus in cesarean section group was less than that in vaginal delivery group,the difference was statistically significant(P<0.05).Conclusions 1 The results of ultrasound elastography showed that the young’s modulus of perineal body of puerpera tended to recover with the extension of time,the degree of recovery of perineal body elasticity was different in different delivery modes,the recovery of vaginal delivery was slower than that of cesarean section,and the puerpera did not return to the state of infertility 6 months after delivery.2 3-D ultrasound showed that the area of levator ani muscle hiatus of puerpera showed a trend of recovery with the extension of time,the recovery degree of levator ani muscle hiatus area was different in different delivery methods,vaginal delivery recovered more slowly than cesarean section,and did not return to the state of infertility 6 months after delivery.Figure6;Table15;Reference 126... |
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