| Objective Through the two-dimensional ultrasonography of the perineal pelvic floor of vaginal delivery and non-fertile women,it provides a reliable imaging basis for postpartum evaluation of pelvic floor function,and explores the application value of two-dimensional ultrasound in female pelvic floor dysfunction.To analyze the effect of vaginal delivery on maternal function in the early postpartum pelvic floor.Methods The 138 maternity of vaginal delivery in our Hospital from July 2017 to December 2017 underwent transvaginal pelvic floor ultrasound examination 42 days after delivery.At the same time,138 cases of married uncultivated women who had no history of abortion and physical health before pregnancy were selected as the control group,and the vaginal pelvic floor ultrasound was performed.In the resting state and the maximum Valsalva state,the measurement of the bladder neck position and mobility,the posterior bladder angle and the urethral rotation angle,the urethral mouth funnelization ?uterine prolapse and rectal bulging rate was compared between the two groups.Resulted(1)The measured parameters of pelvic organs in the two groups were compared The posterior urephravesical angle were(112.19±19.73)° and(109.27±18.65)in the observation group and the control group respectively.There was no significant difference between the two groups(P>0.05);The bladder neck position of the observation group and the control group were(23.23±4.79)mm and(24.65±5.37)mm respectively.The bladder neck position of the observation group was small ower than that of the control group,the difference was not statistically significant(P>0.05).(2)Comparison of measurement parameters of pelvic organs and pelvic organ activity in the maximum Valsalva state of the two groups The posterior angles of the bladder in the observation group and the control group were(137.19±22.85)°and(117.68±10.28)°.respectively.There was significant difference between the two groups(P<0.05);The urethral rotation angles of the observation group and the control group were(43.06±10.31)mm and(26.35±8.97)mm respectively,the bladder neck movements were(17.18±5.08)mm and(12.68±3.21)mm respectively.The urethral rotation angle and bladder neck movement of the observation group were significantly higher than those of the control group,the difference was statistically significant(P<0.05).(3)Comparison of funnelization in the urethra of the two groups The two groups of subjects did not find funnelization in the urethra at rest.In the maximum Valsalva state,4 patients in the control group were found to have funnelization in the urethra.In the observation group,36 maternity of the urethral orifice was found to be funnelized.The difference between them was statistically significant(P<0.05).(4)Comparison of the incidence of rectal bulging in the two groups There were 5case of vesicocele? 1 case of uterine prolapse and 2 cases of rectal bulging were found in the control group.46 case of vesicocele ?23 cases of uterine prolapse and 5 cases of rectal bulging were found in the observation group.The incidence of vesicocele? uterine prolapse and rectal bulging in the observation group were higher than that in the control group(P<0.05).Conclusions(1)By using the perineal pelvic floor ultrasound technique,the anatomical structure,position and functional status of female pelvic organs can be observed dynamically,with percepual intuition?simple operation and good repeatability.(2)Perineal pelvic floor ultrasound technology can assist clinical evaluation of pelvic floor function status of women 42 days after delivery,timely and early detection of postpartum female pelvic floor dysfunction,timely and early rehabilitation(3)Evaluate the clinical value of each indicator by image characteristics and improve the accuracy of clinical diagnosis(4)Transvaginal delivery has different degrees of damage to the structure and function of the pelvic floor,mainly affects the anterior and middle pelvic cavity.The two-dimensional pelvic floor ultrasound of the perineum provides reliable imaging for primipara pelvic dysplasia in accordance withObjective Ultrasound observation of the effect of rehabilitation therapy on the pelvic floor structure of postpartum women,and the comprehensive evaluation of the imaging indicators of the rehabilitation effect of pelvic floor dysfunction,providing an intuitive and reliable imaging basis for clinical?Methods From July 2017 to December 2017,268 women who were hospitalized for vaginal delivery in Suzhou Municipal Hospital detected 80 patients with PFD by two-dimensional ultrasound screening combined with gynecological examination of patients with pelvic organ prolapse quantitative scoring system.,randomly divided into intervention group and control group,each group of 40 cases,The control group only gave routine health education and postpartum health care.The intervention group guided the patients to perform pelvic floor rehabilitation exercise,including electrical stimulation,pelvic floor rehabilitation training,pelvic floor muscle function training,etc.,before and after treatment,ultrasonic testing was performed 2 months after treatment.Measure the thickness of the levator ani muscle ? the anteroposterior diameter,transverse diameter and area of the levator ani muscle in the minimum plane of the resting and maximum Valsalva motion in the smallest air plane in the anorectal state.And statistical analysis of the above parameters?Results(1)Comparison of clinical symptoms between the two groups before and after intervention Before the intervention,the clinical symptoms of leakage,constipation and vaginal relaxation were not statistically significant(P>0.05).After the intervention,the clinical symptoms of leakage,constipation and vaginal relaxation were improved in the observation group.The situation was significantly better than the control group,and the difference was statistically significant(P<0.05).(2)Comparison of ultrasound parameters before and after intervention in two groups of patients at rest There was no significant difference in the area of pelvic sacral hole,the circumference of pelvic sulcus,the anteroposterior diameter of pelvic sulcus,the diameter transversa of pelvic sacral hole and the thickness of levator ani muscle(P>0.05).The area of the hole,the circumference of the pelvic sulcus,the anteroposterior diameter of the pelvic sulcus were smaller than those before the intervention.The difference was statistically significant(P<0.05),and the parameter index was smaller than the control group.The difference was statistically significant(P<0.05).But the diameter transversa of pelvic sacral hole and the thickness of levator ani muscle have a little change,the difference was not significant(P>0.05).(3)Comparison of ultrasound parameters before and after intervention in Valsalva state There was no significant difference in the area of pelvic sacral hole,the circumference of pelvic sulcus,the anteroposterior diameter of pelvic sulcus,the diameter transversa of pelvic sacral hole and the thickness of levator ani muscle(P>0.05).The area of the hole,the circumference of the pelvic sulcus,the anteroposterior diameter of the pelvic sulcus,and the diameter transversa of pelvic sacral hole were smaller than those before the intervention.The difference was statistically significant(P<0.05),and the parameter index was smaller than the control group.The difference was statistically significant(P< 0.05).There was no significant difference in the thickness of levator ani muscle(P>0.05).(4)Comparison of ultrasound parameters before and after intervention in the anorectal state of two groups of patients There was no significant difference in the area of pelvic sacral hole,the circumference of pelvic sulcus,the anterior and posterior diameter of pelvic sulcus,the diameter of pelvic sacral hole and the thickness of levator ani muscle(P>0.05).The area of the hole,the circumference of the pelvic sulcus,the anteroposterior diameter of the pelvic sulcus,the diameter transversa of the pelvic sulcus were smaller than those before the intervention.The difference was statistically significant(P<0.05),and the parameter index was smaller than the control group.The difference was statistically significant(P<0.05).the thickness of the levator ani muscle was thicker than the previous,but the difference is not significant(P>0.05).Conclusions The perineal ultrasound was used to observe the changes of pelvic floor structure before and after pelvic floor rehabilitation.The statistical analysis showed that the pelvic stenosis,puborectal muscle can reflect the changes of pelvic floor structure and function comprehensively and dynamically,which can be used as evaluation of pelvic floor rehabilitation.The important imaging indicators of curative effect are used to evaluate the morphology and function of the pelvic floor,providing a realistic and reliable imaging basis for the clinician. |
PDF Full Text Request