目的应用经会阴实时三维超声评估经阴道分娩和择期剖宫产对产后女性盆膈裂孔的影响。方法以湖南省妇幼保健院2016年1月-2017年6月的303例产后妇女为研究对象,于产后6～8周应用经会阴实时三维超声对经阴道分娩组与剖宫产组受检者的静息状态、缩肛状态和最大Valsalva状态盆膈裂孔面积进行观察与测量。结果两组最大Valsalva状态的盆膈裂孔面积差异有统计学意义(P<0.01);静息状态的盆膈裂孔面积差异有统计学意义(P<0.05);而缩肛状态的盆膈裂孔面积差异无统计学意义(P>0.05)。结论阴道分娩对女性盆膈裂孔面积的近期影响较择期剖宫产大。经会阴实时三维超声评估静息、最大Valsalva状态盆膈裂孔面积的参数变化可用于评估妊娠及分娩方式对盆底的影响。

Objective : Objective To evaluate the effect of vaginal delivery and selective caesarean section on female area of delphragma pelvic hiatus by real-time three-dimensional ultrasound. Methods 303 women who underwent the transperineal real-time three-dimensional ultrasound in 6-8 weeks after childbirth from January 2016-2017 June in Women And Children's Health of Hunan Province were divided as the vaginal delivery group and the cesarean section group. The area of delphragma pelvic hiatus in the resting stage,anal sphincter contracting stage and maximum Valsalva condition was observed and measured. Results There was significant statistical difference inthe delphragma pelvic hiatus areas in maximum Valsalva condition between the two groups( P < 0. 01). There was statistical difference in the delphragma pelvic hiatus area in the resting stage between the two groups( P < 0. 05). However,there was no difference the delphragma pelvic hiatus area in the anal sphincter contracting stage. Conclusion Compare with selective caesarean section,there are more short term influences at the area of delphragma pelvic hiatus by vaginal delivery. According to observe the variation of the delphragma pelvic hiatus area in the resting stage and maximum Valsalva condition by transperineal realtime three-dimensional ultrasound,the effects to the pelvic floor for pregnancy and different delivery methods can be evaluated.