目的 探讨盆底超声参数联合腹直肌分离度（diastasis recti abdominis,DRA）对产后盆腔脏器脱垂（pelvic organ prolapse,POP）的诊断价值。方法 选取我院2023年1月—2024年12月接收的98例产后POP患者作为研究对象,设为POP组。选取同期非POP产妇90例作为对照组。比较两组基本资料、DRA、不同状态下盆底超声参数,采用Pearson分析盆底超声参数、DRA与POP严重程度的相关性,多因素Logistic回归分析产后POP的影响因素,采用受试者工作特征（area under the curve,ROC）曲线评价盆底超声指标、DRA的诊断价值。结果 POP组妊娠史比例、分娩史比例及DRA均显著高于对照组。POP组患者在静息、缩肛及最大Valsalva动作状态下肛提肌裂孔前后径、肛提肌裂孔面积、膀胱尿道后角均显著高于对照组。POP患者盆底超声参数肛提肌裂孔前后径、肛提肌裂孔面积、膀胱尿道后角及DRA均与POP严重程度呈正相关。Logistic多因素分析结果显示,产妇妊娠史、分娩史、DRA及盆底超声参数是产后发生POP的独立危险因素。ROC曲线显示,联合预测概率诊断产后POP的AUC、敏感度均优于各项指标单独诊断及简单并联诊断。结论 盆底超声参数联合DRA能显著提高产后POP的诊断效能,为临床POP诊治提供参考依据。

Objective To explore the diagnostic value of pelvic floor ultrasound parameters combined with diastasis recti abdominis (DRA) for postpartum pelvic organ prolapse (POP). Methods A total of 98 postpartum POP patients admitted to our hospital from January 2023 to December 2024 were selected as the POP group, and 90 postpartum non-POP women during the same period were selected as the control group. Basic data, DRA, and pelvic floor ultrasound parameters under different conditions were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between pelvic floor ultrasound indicators, DRA and the severity of POP. Results The proportion of pregnancy history, delivery history and DRA in the POP group were significantly higher than those in the control group. The anterior-posterior diameter of the levator ani hiatus, the area of the levator ani hiatus and the posterior angle of the bladder urethra in the POP group were significantly higher than those in the control group under resting, anal contraction and maximal Valsalva maneuver conditions. The pelvic floor ultrasound indicators of the POP patients, including the anterior-posterior diameter of the levator ani hiatus, the area of the levator ani hiatus and the posterior angle of the bladder urethra, and DRA were positively correlated with the severity of POP. The results of multivariate Logistic regression analysis showed that pregnancy history, delivery history, DRA and pelvic floor ultrasound indicators were independent risk factors for postpartum POP. The ROC curve showed that the AUC and sensitivity of combined predictive probability in diagnosing postpartum POP were superior to those of individual diagnosis of each index and simple parallel diagnosis. Conclusion The combination of pelvic floor ultrasound and DRA can significantly improve the diagnostic efficiency of postpartum POP, providing a reference basis for the clinical diagnosis and treatment of POP.