超声诊断产后腹直肌分离的初步研究

Preliminary study of ultrasound diagnosis of diastasis recti in postpartum women

  • 摘要: 目的通过评估健康未生育女性和产后女性的腹直肌间距, 探讨高频超声对于诊断产后女性腹直肌分离的可行性。方法选择150名健康无孕产史女性志愿者(未生育组)及167名产后女性(产后组), 使用高频线阵探头分别测量其在平躺状态下脐下3 cm、脐部以及脐上3 cm处的腹直肌间距。比较3组间3个位置的腹直肌间距。使用未生育组获得腹直肌间距正常值的第90、95、99百分位数作为诊断腹直肌分离的诊断界值, 观察不同诊断界值下产后组的发病率。结果在平躺状态下, 未生育组在脐下3 cm、脐部以及脐上3 cm处的腹直肌间距测量值分别为0(0, 1.00)、11.00(7.00, 16.00)、6.00(2.00, 9.00) mm, 产后组则分别为4.00(0, 12.00)、27.00(20.00, 33.00)、23.00(17.00, 29.00)mm。2组的腹直肌间距在3个测量位点比较差异均有统计学意义(P均< 0.001)。以未生育组3个位点腹直肌间距的第90、95、99百分位数为诊断界值, 产后组腹直肌分离的发病率分别为93.4%、85.6%和68.3%。结论使用高频超声多点测量腹直肌间距对于诊断产后女性的腹直肌分离具有较高的可行性。

     

    Abstract: Objective To investigate the feasibility of high-frequency ultrasound for the diagnosis of diastasis recti in postpartum women by assessing the inter-rectus distance (IRD) in healthy nulliparous woman and postpartum women. Method 150 healthy nulliparous volunteers (nulliparous group) and 167 postpartum women (postpartum group) were included in the study. IRD was measured at the 3 cm below the umbilicus, umbilicus and 3 cm above the umbilicus in a supine position using a high-frequency line array probe. The IRD at three sites between the two groups was compared. The 90th, 95th, and 99th percentiles of normal values of the rectus abdominis spacing obtained in the nulliparous group were used as diagnostic cut-off values for diastasis recti, and the morbidity of postpartum group was observed at different cut-off values. Results In a supine position, the IRD at 3 cm below the umbilicus was 0 (0, 1.00)mm, 11.00(7.00, 16.00)mm at the umbilicus, and 6.00(2.00, 9.00)mm at 3 cm above the umbilicus in the nulliparous group, and 4.00 (0, 12.00) mm, 27.00 (20.00, 33.00)mm and 23.00(17.00, 29.00) mm in the postpartum group, respectively. There was significant difference in the IRD at three sites between two groups (all P < 0.001). Taking the 90th, 95th and 99th percentiles as the diagnostic cut-off values, the prevalence rates of diastasis recti in the postpartum group were 93.4%, 85.6% and 68.3%, respectively. Conclusion IRD multipoint measurement by high-frequency ultrasound is highly feasible for diagnosing diastasis recti in postpartum women.

     

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