林梅清　古艳

【摘要】 目的：了解经会阴3D超声探查产后妇女便秘的盆底变化。方法：选取2012年1月-2013年12月本院收治的40例产后妇女，随机分为有便秘症状组和没有便秘症状组各20例，观察Valsalva动作前、后、中盆腔的情况，静息、Valsalva动作时的肛提肌裂孔的变化。结果：有便秘症状组在盆底超声检查中出现盆底结构异常改变的例数明显高于没有便秘症状组，有便秘症状组无论是静息或Valsalva动作时肛提肌的前后径、左右径、面积及周长均明显大于没有便秘症状组，差异均有统计学意义（P<0.05）。结论：经会阴3D超声探查产后妇女便秘的盆底变化具有一定的临床指导意义。

【关键词】 经会阴3D超声； 便秘； 产后妇女

【Abstract】 Objective：To understand the pelvic floor change in postpartum female with constipation by perineum 3D ultrasonography.Method：40 postpartum female treated in our hospital from January 2012 to December 2013 were selected，they were randomly divided into the symptoms of constipation group and no symptoms of constipation group，20 cases in each group.Anterior，middle，posterior pelvic prolapse during Valsalva maneuver，and levator hiatus during resting and Valsalva maneuver were observed by perineum 3D ultrasonography.Result：The number of abnormal changes of pelvic floor structure in the symptoms of constipation group was significantly higher than that in no symptoms of constipation group，diameter，area and perimeter both before and after resting or Valsalva action of the levator in the symptoms of constipation group were significantly greater than those in no symptoms of constipation group the difference was statistically significant（P<0.05）.Conclusion：Perineum 3D ultrasonography has great value for pelvic floor change in postpartum female with constipation.

【Key words】 Perineum 3D ultrasonography； Constipation； Postpartum female

女性盆底功能障碍性疾病又称盆底缺陷，是各种病因导致盆底支持结构薄弱而造成盆腔脏器位置和功能异常的一组疾病，包括压力性尿失禁、盆腔器官脱垂（如子宫脱垂、阴道前壁膨出、直肠膨出等）、性功能障碍、慢性盆腔疼痛，严重影响女性健康和生活质量，是一个在全球范围内日益受到重视的社会卫生问题[1]。随着产后妇女的不断增多，实际发病率越来越高。其中盆底功能障碍所致便秘的发病率高，不仅出现排便障碍，而且可出现由于排便障碍导致的失眠、烦躁、注意力不集中、口臭、肛门会阴部坠胀、疼痛等一组亚健康症状，且患者不知如何就诊。本文主要探讨出现便秘症状的产后妇女的盆底功能变化，随机将其分为有便秘症状组和无便秘症状组各20例，应用彩色多普勒3D超声仪，分析有没有盆底异常结构变化，并对上述数据进行统计分析并得出结论。……