盆腔造影结合排粪造影对盆底疝的诊断价值

Pelviography combined with defecography in the diagnosis of pelvic floor hernia

目的 评价盆腔造影结合排粪造影对盆底疝的诊断价值 ,指导临床治疗方案的选择。方法 对 5 0例正常人(对照组 )及 2 78例有排便困难、盆底沉重感患者 (异常组 )作了盆腔造影结合排粪造影检查 ,测量了盆底腹膜反折的位置。结果 对照组肛直肠及盆底形态未见异常。异常组中 ,肛直肠形态异常者 2 76例。盆底形态位置正常者 12 4例 ,6例盆腔造影失败。盆底疝 14 8例 ,其中 112例直肠腹膜疝 ,2 2例间隔腹膜疝 ,11例阴道腹膜疝 ,3例网膜腹膜疝。盆底疝多伴随直肠粘膜脱垂及直肠套叠发生 ,不发生于盆底肌痉挛综合征患者。结论 盆腔造影结合排粪造影是诊断盆底疝的可靠方法 。

Objective To evaluate the diagnostic value of pelviography combined with defecography in diagnosis of pelvic floor hernia in order to provide options for clinical therapy. Methods A total of 278 patients with defecation disorder and pelvic heaviness (the abnormal group) and 50 healthy people (the control group) were examined by pelviography combined with defecography, and the position of peritoneal reflexum of the pelvic floor was measured. Results In the control group, no morphologic abnormality was found in the anorectal and pelvic floor. In the abnormal group, morphological abnormality in the anorectum was found in 276 cases. The morphologic position of the pelvic floor was normal in 124 cases. Pelviography failed in 6 patients. Pelvic floor hernia was found in 148 cases, including 112 cases of rectal peritoneocele, 22 cases of septal peritoneocele, 11 cases of vaginal peritoneocele, and 3 cases of omental peritoneocele. Pelvic floor hernia was mostly accompanied by rectal mucosal prolapse and rectal intussusception, but without spastic pelvic floor syndrome. Conclusion Pelviography combined with defecography is a reliable method in diagnosis of pelvic floor hernia. It can provide reliable objective basis for the choice of clinical therapy.