摘要
目的:探究三维盆底超声在妊娠、阴道分娩盆底功能评估中的应用价值.方法:选取2021年1月至2021年6月在我院行三维盆底超声检查60例妊娠晚期孕妇和60例阴道分娩后42天产妇进行前瞻性研究.由甲、乙两名超声医生随机进行三维盆底超声检查,记录膀胱颈移动度(BND)、尿道旋转角度(?α)、Valsalva状态下尿道倾斜角(UTA)以及Valsalva动作状态下肛提肌最小裂孔的面积(LA)以及静息和Valsalva状态下差值(?LA).采用组内相关系数(ICC)评估不同超声医生之间测量结果的一致性,采用Kappa一致性检验分析经会阴超声成像与综合诊断结果的一致性.结果:妊娠、阴道分娩女性中BND、?α、UTA、LA、?LA的测量值,甲、乙超声医生相比,差异无统计学意义(P>0.05),一致性较好(ICC均>0.800,P=0.000).三维盆底超声检测,甲超声医生盆底功能障碍性疾病检出率为38.33%(46/120),乙超声医生检出率为40.83%(49/120),其检测结果较为一致(Kappa=0.913;P=0.000).经综合诊断,女性盆底功能障碍性疾病检出率31.67%(38/120),其结果分别与甲、乙超声医生三维盆底超声检测结果较为一致(Kappa=0.818,0.803;P=0.000).三维盆底超声联合综合诊断的结果分析,妊娠晚期孕妇盆底功能障碍性疾病检出率5(8.33%)明显低于阴道分娩产妇31(51.67%)(χ2=26.83,P<0.05).结论:采用三维盆底超声对妊娠、阴道分娩女性进行盆底功能评估,具有较高的诊断准确性和重复性,值得临床应用.
Objective:To explore the application value of 3D-pelvic floor ultrasound in the evaluation of pelvic floor function during pregnancy and vaginal delivery.Methods:60 pregnant women in the third trimester of pregnancy and 60 pregnant women 42 days after vaginal delivery who underwent 3D-pelvic floor ultrasound in our hospital which were from January 2021 to June 2021 were collected for prospective study.A and B ultrasound doctors randomly performed three-dimensional pelvic ultrasound examinations on pregnant women and vaginal delivery women,and recorded and calculated bladder neck movement(BND),urethral rotation angle(Aa),urethral inclination angle(UTA)and area of the smallest hole of the levator ani muscle(LA)in the Valsalva state,and difference between resting and Valsalva state(ALA).The intra-group correlation coefficient(ICC)was used to evaluate the consistency of the measurement results between different ultrasound doctors,and the Kappa consistency test is used to analyze the consistency between the perineal ultrasound imaging and the comprehensive diagnosis result.Results:There was no significant difference in the measured values of BND,Aa,UTA,LA,and ALA between the pregnant and vaginal delivery women of doctor A and the doctor of ultrasound B(P>0.05),and the results of intra-group correlation coefficient showed that there was good agreement between A and B ultrasound doctors(ICC were both>0.800,P=0.000).According to the results of 3D-pelvic floor ultrasound,the detection rate of pelvic floor dysfunction disease by ultrasound doctor A was 38.33%(46/120),and that of ultrasound doctor B was 40.83%(49/120).Kappa consistency analysis indicated that the 3D-pelvic floor ultrasound results of doctor A were in good agreement with doctor B(Kappa=0.913;P=0.000).After comprehensive diagnosis,the detection rate of pelvic floor dysfunction disease in 120 women in pregnancy and vaginal delivery was 31.67%(38/120).Kappa consistency analysis showed that the comprehensive diagnosis results were in good agreement with the 3D-pelvic floor ultrasound results of ultrasound doctor A and ultrasound doctor B respectively(Kappa=0.818,0.803;P=0.000).Analysis of the results of 3D-pelvic floor ultrasound combined with comprehensive diagnosis showed that the detection rate of pelvic floor dysfunction in third trimester pregnant women 5(8.33%)was significantly lower than that of vaginal delivery women 31(51.67%)(x2=26.83,P<0.05).Conclusion:The use of 3D-pelvic floor ultrasound to evaluate the pelvic floor function of pregnant women and vaginal delivery women has high diagnostic accuracy and repeatability,which is worthy of clinical application.
作者
康颖秋
Kang Yin-qiu(Department of Ultrasound,Ningling County Maternal and Child Health Hospital,Shangqiu,476700,Henan,China)
出处
《四川生理科学杂志》
2021年第8期1362-1365,共4页
Sichuan Journal of Physiological Sciences
关键词
盆底功能障碍疾病
三维盆底超声
妊娠
阴道分娩
Pelvic floor dysfunction disease
3D-pelvic floor ultrasound
Pregnancy
Vaginal delivery
