消痔灵注射治疗女性中后盆腔器官脱垂的三重造影观察

Use of triple-organography in evaluating effectiveness of Xiaozhiling injection in treating women with middle-rear pelvic organ prolapse

目的总结应用三重造影技术观察消痔灵注射治疗女性中后盆腔器官脱垂疗效的体会。方法以15例女性中后盆腔器官脱垂患者为研究对象,采取直肠及阴道周围注射法治疗,观察治疗前1 d与治疗后第15 d三重造影检查结果,并以耻尾线、近似直肠轴线、肛管轴线为标准线测量治疗前后肛直角、耻尾线肛上距、骶直间距、骶尾曲率、直肠最远端距离耻尾线的距离、阴道内浸钡纱条下降距离以及血液学指标。结果治疗前,三重造影检出直肠脱垂15例、子宫脱垂9例、小肠脱垂2例、肛直肠连接过度下降15例,治疗后检查提示直肠脱垂1例、小肠脱垂1例。治疗前后前后静息期与力排期的肛直角差异均无统计学意义(均P> 0.05)。治疗后静息期与力排期的肛上距短于治疗前,下降值小于治疗前(均P <0.05)。治疗前后骶直间距和骶尾曲度差异均无统计学意义(均P> 0.05)。治疗后静息期与力排期直肠最远端与耻尾线的距离短于治疗前,下降值小于治疗前(均P <0.05)。治疗后静息期浸钡纱条下降距离短于治疗前,力排期浸钡纱条下降距离短于治疗前,下降值减小治疗前(均P <0.05)。治疗后第1 d中性粒细胞百分比及CRP水平高于治疗前,治疗后第3 d CRP水平高于治疗前(均P <0.05)。治疗后第1 d、3 d、5 d WBC、RBC、PLT、HGB、Cr、BUN、ALT与治疗前相比,差异均无统计学意义(均P> 0.05)。结论三重造影术可用于较全面评价女性中后盆腔器官的脱垂和盆底病变,但亦存在一定局限性,消痔灵直肠及阴道周围注射治疗女性中后盆腔器官脱垂疗效肯定,创伤小,经济安全。

Objectives To use triple-organography to evaluate effectiveness of Xiaozhiling injection in treating women with middle-rear pelvic organ prolapse.Methods Fifteen women with middle-rear pelvic organ prolapse were recruited as study subjects.They were treated with rectal and perivaginal injection.Triple-organography was performed 1 day before and 15 days after treatment.Anal rectangle,distance between anus and pubic-coccygeal line,distance between sacrum and rectum,sacrococcygeal curvature,distance between distal-most rectum and pubic-coccygeal line,and descending distance of barium-impregnated gauze in vagina were measured based on pubic-coccygeal line,approximate rectal axis and anal axis.These indices and hematological indices were measured before and after treatment.Results Before treatment,there were 15 rectal prolapse,9 uterine prolapse,2 small intestinal prolapse and 15 excessive decrease of anorectal junction.After treatment,there were 1 rectal prolapse and 1 small intestinal prolapse.There was no significant difference in anal rectangle during resting and forced drainage period before and after the treatment(P>0.05).The distance between anus and pubic-coccygeal line during resting and forced drainage period was significantly smaller after treatment than before and the decrease was significantly smaller after treatment than before(P<0.05).There was no significant difference in distance between sacrum and rectum or sacrococcygeal curvature before and after treatment(P>0.05).The distance between distal-most rectum and pubic-coccygeal line during resting and forced drainage period was significantly smaller after treatment than before and the decrease was significantly smaller after treatment than before(P<0.05).The descending distance of barium-impregnated gauze in vagina during resting period was smaller after treatment than before.During forced drainage period it was shorter after treatment than before and the decrease was smaller after treatment than before treatment(P<0.05).Percentage of neutrophils and the level of CRP one day after treatment was significantly higher after treatment than before and CRP level three days after treatment was significantly higher after treatment than before(P<0.05).WBC,RBC,PLT,HGB,Cr,BUN and ALT levels 1,3,5 days after treatment were similar to those before treatment(P>0.05).Conclusion Triple-organography could be used for comprehensive evaluation of middle-rear pelvic organ prolapse or pelvic disorders in women,but it has its limitation.Rectal and perivaginal Xiaozhiling injection is an effective,less invasive,safe and low-cost treatment for women with middle-rear pelvic organ prolapse.