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目的:应用经阴道三维盆底超声参数评价不同分娩方式对女性盆底功能和结构的影响。方法:抽取2017年5月至2019年8月济宁医学院附属湖西医院接诊的419例产后6~8周行盆底检查女性,根据分娩方式将其分为阴道分娩组(208例)和剖宫产组(211例)。记录阴道分娩次数。另选择200例未生育健康女性为对照组。采用经阴道三维盆底超声测量肛提肌裂孔面积、前后径、内外径、膀胱颈角度、膀胱旋转角度、膀胱颈移动度。结果:阴道分娩组静息、Valsalva状态下肛提肌裂孔面积、前后径、左右径、静息膀胱颈角度、Valsalva膀胱颈角度、膀胱旋转角度、膀胱颈移动度大于剖宫产组和对照组(n P<0.05),剖宫产组静息、Valsalva状态下肛提肌裂孔面积、前后径、左右径、静息膀胱颈角度、Valsalva膀胱颈角度、膀胱旋转角度、膀胱颈移动度大于对照组(n P<0.05)。阴道分娩组静息、Valsalva状态下提肌裂孔面积、前后径、左右径、静息膀胱颈角度、Valsalva膀胱颈角度、膀胱旋转角度、膀胱颈移动度随阴道分娩次数的增加而增加(n P<0.05),不同阴道分娩次数亚组比较差异有统计学意义(n P<0.05)。n 结论:阴道分娩、剖宫产均对女性盆底功能和结构产生一定影响,阴道分娩影响更为显著,且随阴道分娩次数增加,盆底功能和结构损伤加重。经阴道三维盆底超声参数可为女性盆底结构和功能评估提供可靠依据。“,”Objective:To explore the value of transvaginal three-dimensional pelvic floor ultrasound parameters in evaluating pelvic floor structure and function of women with different parturition methods.Methods:A total of 419 women with pelvic floor examination in Huxi Hospital Affiliated to Jining Medical College from May 2017 to August 2019 were divided into vaginal parturition group (208 cases) and cesarean section group (211 cases) according to the parturition mode.The times of vaginal parturition were recorded. Another 200 healthy women were selected as the control group.The area of levator ani hiatus, anteroposterior diameter, internal and external diameter, bladder neck angle, bladder rotation angle and bladder neck movement were measured by transvaginal three-dimensional pelvic floor ultrasound.Results:The area of levator ani hiatus, anteroposterior diameter, left and right diameter, resting bladder neck angle, Valsalva bladder neck angle, bladder rotation angle and bladder neck movement in vaginal parturition group were larger than those in cesarean section group and control group (n P<0.05). The area of levator ani hiatus, anteroposterior diameter, left and right diameter, resting bladder neck angle, Valsalva bladder neck angle, bladder rotation angle and bladder neck movement of cesarean section group were larger than those of control group (n P<0.05). In vaginal parturition group, the area of levator muscle hiatus, anteroposterior diameter, left and right diameter, resting bladder neck angle, Valsalva bladder neck angle, bladder rotation angle and bladder neck movement increased with the increase of vaginal parturition times(n P<0.05), there was significant difference in subgroup of different vaginal parturition times (n P<0.05).n Conclusions:Vaginal parturition and cesarean section have certain influence on the function and structure of female pelvic floor, and the influence of vaginal parturition is more significant, and the damage of pelvic floor function and structure increases with the number of vaginal parturition. The three-dimensional ultrasound parameters based on transvaginal can provide reliable basis for the evaluation of female pelvic floor structure and function.