三维超声对女性盆腔器官脱垂患者耻骨直肠肌形态的检测价值

Value of three-dimensional ultrasound in the detection of the puborectal muscle morphology of female patients with pelvic organ prolapse

目的探讨三维超声对女性盆腔器官脱垂患者耻骨直肠肌形态的检测价值。方法选取我院妇产科2013年1月至2015年12月期间所收治盆腔器官脱垂患者47例作为观察组,另从因妇科良性疾病就诊的女性患者中随机抽取47例作为对照组。均予以三维超声检查,对比盆腔器官脱垂患者与正常女性的三维超声表现,测量膈裂孔前后径、左右径、周长、面积及耻骨直肠肌厚度并进行比较。结果盆腔器官正常女性的三维超声图像示膈裂孔面积较小、结构紧凑,多为菱形或类菱形。耻骨直肠肌呈U或V字襻形,两侧对称且连续,回声均匀,尿道、阴道及直肠被耻骨直肠肌包绕。盆腔器官脱垂患者则膈裂孔面积增大,结构松散,呈现圆形或类圆形,两侧不对称,多有撕裂损伤,尿道、阴道及直肠等脏器膨出、结构松散。盆腔器官脱垂患者膈裂孔前后径、左右径、周长、面积及耻骨直肠肌厚度均显著高于对照组,差异有统计学意义(P<0.05)。结论三维超声检查具有软组织分辨率高、操作简便、经济性与安全性高的优点,利于女性盆膈裂孔及耻骨直肠肌形态学特点的良好显示,且可对盆膈裂孔大小及耻骨直肠肌厚度进行测量,可为盆腔器官脱垂的预防、诊断及治疗提供客观依据,具有较大应用价值。

Objective To explore the value of three-dimensional ultrasound in the detection of the puborectal muscle morphology of female patients with pelvic organ prolapse. Methods 47 cases of patients with pelvic organ prolapse treated in the department of gynaecology and obstetrics of our hospital from January 2013 to December 2015 were selected as the observation group, 47 cases of female patients with benign gynecologic diseases were selected as the control group randomly. All patients underwent three-dimensional ultrasound, three-dimensional ultrasonographic features of pelvic organ prolapse patients and normal women were compared, anteroposterior di- ameter, left-right diameter, perimeter, area of diaphragmatic hiatus and thickness of puborectal muscle were measured and compared. Results Three-dimensional ultrasound images of female with normal pelvic organ showed that area of diaphragmatic hiatus were small with compact structure, most were diamond or quasi-rhom- bus. Puborectal muscle were U or V loop shaped, both sides were symmetrical and continuous, the echoes were even, puborectal muscle were wrapped around urethra, vagina and rectum. Area of diaphragmatic hiatus of patients with pelvic organ prolapse were incresed with loose structure, they were round or quasi-circular, both sides were unsymmetrical, most were tearing and damage, urethra, vagina and rectum and other organs were prolapsed with loose structure. Anteroposterior diameter, left-right diameter, perimeter, area of diaphragmatic hiatus and thickness of puborectal muscle of patients with pelvic organ prolapse were significantly higher than the control group （P〈0.05）. Conclusion Three-dimensional ultrasound has the advantages of high soft tissue resolution, simple operation, economical and high security, is beneficial to show female pelvic diaphragmatic hiatus and puborectal muscle morphological characteristics better, it can be used to measure size of pelvic diaphragmatic hiatus and thickness of puborectal muscle, can provide an objective basis for the prevention, diagnosis and treatment of pelvic organ prolapse, and has big application value.