摘要
目的探讨采用经会阴盆底三维超声测量不同状态下盆膈裂孔的形态和各参数变化,评估子宫全切术后患者盆底功能。方法选取2015年12月到2016年12月子宫全切术后1年的50例患者作为观察组;月经不调、阴道炎等疾病来我院就诊的50例未行子宫切除术患者作为对照组。经会阴三维超声观察两组患者静息、valsava和缩肛状态下盆膈裂孔的形态及参数变化,并比较两组参数的统计学差异。结果所有患者均可清晰显示盆膈裂孔图像,并可准确测量其前后径、横径、厚度及面积;在静息、valsava及缩肛状态下,观察组盆膈裂孔前后径、面积及耻骨直肠肌厚度均大于对照组(P<0.05,P<0.01);但缩肛状态下,盆膈裂孔横径两组比较无统计学意义(P>0.05);盆底超声测量结果结合临床诊断子宫全切术后盆底功能障碍28例。结论经会阴三维超声可动态观察不同状态下盆膈裂孔形态和各参数变化,并为临床诊断盆底功能障碍性疾病提供循证数据参考。
Objective To discuss the changes of morphology and parameters of hiatus of pelvic diaphragm in different states measured by transperineal pelvic floor three-dimensional ultrasonography in order to evaluate pelvic floor function after hysterectomy. Methods From December 2015 to December 2016,50 patients after hysterectomy for 1 years were included as the observation group. The postpartum women in 50 cases were selected because of irregular menstruation,vaginitis and other symptoms in our hospital gynecology clinic without hysterectomy as control group. The inferior edge of the pubic symphysis was used as the reference point,and the changes of morphology and parameters of the pelvic diaphragm in the resting state,the Valsava and the constriction of the anus were observed by transperineal three-dimensional ultrasound. The statistical differences between the two groups of parameters were compared. Results The pelvic diaphragm image,the posterior diameter,diameter,thickness and area can be measured accurately and display clearly in all patients. In the resting state,Valsava state and the constriction of the anus,the anteroposterior diameter and area of the pelvic diaphragm hiatus and the thickness of the puborectalis in the observation group were higher than that in the control group( P < 0. 05,P < 0. 01). But in the anal contraction state,two groups of pelvic diaphragm hiatus diameter was not statistically significant( P > 0. 05). The pelvic floor dysfunction occurred in 28 cases with pelvic floor ultrasonographycombined with clinical diagnosis of after hysterectomy. Conclusion Three-dimensional ultrasonography of the perineum can be used to observe the morphological changes of the pelvic cavity and the changes of the parameters,which provides evidence-based data for the clinical diagnosis of pelvic floor dysfunction.
出处
《济宁医学院学报》
2017年第4期291-294,共4页
Journal of Jining Medical University
基金
山东省科技发展计划项目(2014GGB14120)
关键词
经会阴三维超声
盆膈裂孔
子宫全切术后
盆底功能障碍
Transperineal three-dimensional ultrasound
Pelvic diaphragm hiatus
Hysterectomy
Pelvic floor dysfunction
