Clinical Investigation of the Effects of Low-intensity Ultrasound Irradiation on Involution of Uterus After Delivery

doi:10.3877/cma.j.issn.1673-5250.2014.01.005

Objective

To investigate the effects of low-intensity ultrasound irradiation on involution of uterus after delivery.

Methods

From June 2012 to December 2012, a total of 141 cases delivered in the First Affiliated Hospital of Chongqing Medical University were studied. Using the single blind method (The patient didn't know whether be treated or not) , and they were divided into 4 groups: caesarean section treatment group (n=46) ,caesarean section control group (n=34) ,natural childbirth treatment group (n=30) and natural childbirth control group (n=31) ,according to the different childbirth way and whether by low-intensity ultrasound irradiation. The first treatment began in the first 6 hours after natural childbirth, compared with 24 hours who has the cesarean section. The treatment group received the ultrasound therapy 2 times a day, for 30 minutes every time, a overall treatment of 5 times; Operation method of control group was consistent with treatment group, but no ultrasound energy output. Observe the decline of fundus uteri, lochia clear time after delivery and visual analog scale score before and after the treatment. The maternal ages and other clinical characteristics of each group had no significant difference (P>0.05) . The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of the First Affiliated Hospital of Chongqing Medical University. Informed consent was obtained from each participating patient.

Results

The fundus decline index of treatment group was obviously better than the control group (H =31.710 0, 34.390 0, P<0.05) ,and the lochia clear time was significantly shorter than the control group (H=5.927 0, 6.343 5, P<0.05) ．The visual analog scale (Vas) score of caesarean section treatment group had significant difference compared with the control group before and after treatment (P<0.05) , but there has no signifficant difference between two groups of natural childbirth of Vas score (P >0.05) .

Conclusions

The low-intensity ultrasound and shorten lochia clear time. It can alleviated the cesarean section uterine pain but not work for eutocia puerpera. irradiation can promote the involution of uterus and shorten lochia clear time. It can alleviate the cesarean section uterine pain but not work for eutocia puerpera.

Key words: Ultrasonic therapy, Cesarean section, Natural childbirth, Uterus

图1 "韵产康"超声波子宫复旧仪

Figure 1 "Yun Chan Kang" ultrasonic therapy apparatus for uterine involution

表1 两组产妇一般情况比较（±s）

Table 1 Comparison of clinical characteristics of two groups（±s）

组别	n	年龄(岁)	体质量指数(kg/m²)	新生儿体质量(kg)	初始宫高(cm)
剖宫产治疗组	46	28.16±2.56	25.60 ± 4.06	3 313.63±304.31	18.51±1.65
剖宫产对照组	34	27.50±2.65	27.78 ± 3.08	3 335.19 ± 383.97	17.96±1.91
t		0.880 0	－0.710 0	－0.660 0	1.600 0
P		0.380 6	0.480 5	0.510 2	0.113 5

表1 两组产妇一般情况比较（±s）

Table 1 Comparison of clinical characteristics of two groups（±s）

组别	n	年龄(岁)	体质量指数(kg/m²)	新生儿体质量(kg)	初始宫高(cm)
剖宫产治疗组	46	28.16±2.56	25.60 ± 4.06	3 313.63±304.31	18.51±1.65
剖宫产对照组	34	27.50±2.65	27.78 ± 3.08	3 335.19 ± 383.97	17.96±1.91
t		0.880 0	－0.710 0	－0.660 0	1.600 0
P		0.380 6	0.480 5	0.510 2	0.113 5

表2 两组产妇一般情况比较（±s）

Table 2 Comparison of clinical characteristics of two groups（±s）

组别	n	年龄(岁)	体质量指数(kg/m²)	新生儿体质量(kg)	初始宫高(cm)
顺产治疗组	30	27.89±3.67	26.88±4.73	3 295.00 ± 342.95	17.95±1.88
顺产对照组	31	26.83±3.91	25.20±6.46	3 276.43 ± 338.44	18.30±1.94
t		1.310 0	0.100 0	0.090 0	－0.280 0
P		0.194 8	0.920 2	0.924 9	0.780 3

表2 两组产妇一般情况比较（±s）

Table 2 Comparison of clinical characteristics of two groups（±s）

组别	n	年龄(岁)	体质量指数(kg/m²)	新生儿体质量(kg)	初始宫高(cm)
顺产治疗组	30	27.89±3.67	26.88±4.73	3 295.00 ± 342.95	17.95±1.88
顺产对照组	31	26.83±3.91	25.20±6.46	3 276.43 ± 338.44	18.30±1.94
t		1.310 0	0.100 0	0.090 0	－0.280 0
P		0.194 8	0.920 2	0.924 9	0.780 3

表3 治疗后两组产妇宫底下降指数及恶露结束时间比较（±s）

Table 3 Comparison of fundus decline index and lochia clear time of two groups（±s）

组别	n	宫底下降指数(%)	恶露结束时间(d)
剖宫产治疗组	46	16.49±6.44	5.76±2.53
剖宫产对照组	34	7.13±6.68	7.15±3.22
H		31.710 0	5.927
P		<0.000 1	<0.050 0

表3 治疗后两组产妇宫底下降指数及恶露结束时间比较（±s）

Table 3 Comparison of fundus decline index and lochia clear time of two groups（±s）

组别	n	宫底下降指数(%)	恶露结束时间(d)
剖宫产治疗组	46	16.49±6.44	5.76±2.53
剖宫产对照组	34	7.13±6.68	7.15±3.22
H		31.710 0	5.927
P		<0.000 1	<0.050 0

表4 治疗后两组产妇宫底下降指数及恶露结束时间比较（±s）

Table 4 Comparison of fundus decline index and lochia clear time of two groups（±s）

组别	n	宫底下降指数(%)	恶露结束时间(d)
顺产治疗组	30	21.84±6.44	6.30 ± 2.65
顺产对照组	31	9.72±4.51	8.42 ± 3.84
H		34.390 0	6.343 6
P		<0.000 1	<0.050 0

表4 治疗后两组产妇宫底下降指数及恶露结束时间比较（±s）

Table 4 Comparison of fundus decline index and lochia clear time of two groups（±s）

组别	n	宫底下降指数(%)	恶露结束时间(d)
顺产治疗组	30	21.84±6.44	6.30 ± 2.65
顺产对照组	31	9.72±4.51	8.42 ± 3.84
H		34.390 0	6.343 6
P		<0.000 1	<0.050 0

表5 两组治疗前后Vas评分差值变化比较（±s）

Table 5 Comparison of the visual analog scales difference before and after treatment of two groups（±s）

组别	n	Vas评分差值(治疗前－治疗后)
组别	n	治疗1次	治疗2次	治疗3次	治疗4次	治疗5次
剖宫产治疗组	46	0.79 ± 0.97	0.75 ± 0.99	0.68 ± 0.79	0.73±1.06	0.65±1.14
剖宫产对照组	34	－0.01 ± 0.68	0.22 ± 0.59	0.23 ± 0.54	0.22 ± 0.48	0.14±0.41
H		16.619 9	6.546 2	4.798 5	6.926 2	6.549 7
P		0.000 1	0.010 5	0.044 4	0.008 5	0.010 5

表5 两组治疗前后Vas评分差值变化比较（±s）

Table 5 Comparison of the visual analog scales difference before and after treatment of two groups（±s）

组别	n	Vas评分差值(治疗前－治疗后)
组别	n	治疗1次	治疗2次	治疗3次	治疗4次	治疗5次
剖宫产治疗组	46	0.79 ± 0.97	0.75 ± 0.99	0.68 ± 0.79	0.73±1.06	0.65±1.14
剖宫产对照组	34	－0.01 ± 0.68	0.22 ± 0.59	0.23 ± 0.54	0.22 ± 0.48	0.14±0.41
H		16.619 9	6.546 2	4.798 5	6.926 2	6.549 7
P		0.000 1	0.010 5	0.044 4	0.008 5	0.010 5

表6 两组治疗前后Vas评分差值变化比较（±s）

Table 6 Comparison of the visual analog scales difference before and after treatment of two groups（±s）

组别	n	Vas评分差值(治疗前-治疗后)
组别	n	治疗1次	治疗2次	治疗3次	治疗4次	治疗5次
顺产治疗组	30	0.03 ± 0.18	－0.07 ± 0.37	0.03 ± 0.32	0.23 ± 0.57	0.27±0.45
顺产对照组	31	0.03 ± 0.18	0.06 ± 0.25	0.10 ± 0.30	0.13 ± 0.56	0.35 ± 0.61
H		0.000 5	2.935 3	0.612 2	1.439 0	0.123 2
P		0.981 3	0.086 7	0.434 0	0.230 3	0.725 6

表6 两组治疗前后Vas评分差值变化比较（±s）

Table 6 Comparison of the visual analog scales difference before and after treatment of two groups（±s）

组别	n	Vas评分差值(治疗前-治疗后)
组别	n	治疗1次	治疗2次	治疗3次	治疗4次	治疗5次
顺产治疗组	30	0.03 ± 0.18	－0.07 ± 0.37	0.03 ± 0.32	0.23 ± 0.57	0.27±0.45
顺产对照组	31	0.03 ± 0.18	0.06 ± 0.25	0.10 ± 0.30	0.13 ± 0.56	0.35 ± 0.61
H		0.000 5	2.935 3	0.612 2	1.439 0	0.123 2
P		0.981 3	0.086 7	0.434 0	0.230 3	0.725 6

[1]	阎莉．剖宫产术对子宫复旧的影响[J]．中国妇幼保健，2004，19(20):54-55．
[2]	肖娟，张海燕，张琳琳，等．产后子宫复旧不良发生现况分析[J]．中国社区医师，2010(27):42-43．
[3]	Terhaar GR，Dyson M，Talbert D．Ultrasonically induced contractions in mouse uterine smooth muscle in vivo[J]．Ultrason，1978，16(6):275-276．
[4]	常淑芳，朱深银，王智彪，等．超声体外诱导大鼠子宫平滑肌收缩的实验研究[J]．中华物理医学与康复杂志，2006，28(7):450-452．
[5]	张瑛，孙江川，常淑芳，等．低强度超声引发大鼠子宫平滑肌收缩的量效关系研究[J]．第三军医大学学报，2007，29(16):1566-1568．
[6]	王文平，孙江川，常淑芳，等．低强度超声诱导人产后离体子宫平滑肌收缩[J]．中国医学影像技术，2009，25(6):953-955．
[7]	Hsu SH，Huang TB．Bio-effect of ultrasound on endothelial cells in vitro [J]．Biomol Eng，2004，21(3-5):99-104．
[8]	Heinemann U．Basic mechanisms of partial epilepsies[J]．Curr Opin Neurol，2004，17(2):155-159．
[9]	Sombati S，Delorenzo RJ．Recurrent spontaneous seizure activity in hippocampal neuronal networks in culture[J]．J Neurophysiol，1995，73(4):1706-1711．
[10]	李力，易萍．产后出血及其临床救治[J]．中国实用妇科与产科杂志，2011，27(2):99-102．
[11]	戴芸．钙离子在胃肠平滑肌收缩机制中的作用[J]．国外医学：消化系疾病分册，2002，22(1):17-20．
[12]	刘茂林，杨晓秋．阿是超声波治疗仪治疗软组织疼痛的疗效观察[A]．中华医学会疼痛学分会第八届年会暨CASP成立二十周年论文集，2009: 193．

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