经会阴超声诊断前盆腔脏器脱垂类型

Transperineal ultrasonography in diagnosis types of anterior compartment organ prolapse

目的探讨经会阴超声对前盆腔脏器脱垂类型的诊断价值。方法对经临床盆腔器官脱垂定量分期法(POPQ)诊断的68例前盆腔脏器脱垂(膀胱尿道膨出28例,孤立性膀胱膨出40例)产妇行经会阴超声检查,以经耻骨联合下缘的水平线为参考,在静息状态和最大Valsaval动作时观察膀胱后壁和尿道的活动情况,测量膀胱尿道后角以及尿道倾斜角,并对经会阴超声结果与临床POP-Q诊断结果进行一致性检验,计算Kappa值。结果经会阴超声诊断膀胱尿道膨出29例,孤立性膀胱膨出39例,与临床POP-Q诊断具有较好的一致性(Kappa=0.55,P<0.001)。结论经会阴超声能够诊断前盆腔脏器脱垂类型,可作为临床判断前盆腔脏器的脱垂的影像学方法而加以推广。

Objective To investigate the valve of transperineal ultrasonography for diagnosing different types of anterior compartment organ prolapse. Methods A total of 68 puerpera with anterior compartment organ prolapse （28 cases of cys- tourethrocele and 40 cases of isolated cystocele） diagnosed with pelvic organ prolapse quantification （POP-Q） examination were enrolled, and transperineal ultrasonography was performed in all of them. Taking inferior margin of pubic symphysis as reference, the degrees of retrovesical angle and urethral rotation were measured both at rest and on maximum Valsalva maneuver. The ultrasonic results were compared with POP-Q examination, and the agreement between ultrasound and POP-Q examination was analyezd. Results Cystourethrocele was diagnosed in 29 patients, while isolated cystocele was di- agnosed in 39 cases with transperineal ultrasonography. Ultrasonic findings showed good agreement with clinical POP-Q examination （Kappa=0. 55, P〈0. 001）. Conclusion Transperineal ultrasonography can be used to distinguish different types of anterior compartment organ prolapse, which is a good imaging method to diagnose anterior compartment organ prolapse in clinical practice.