超声分析盆底失弛缓综合征便秘女性盆底肌的运动特征

Pelvic floor ultrasound analysis of muscle movement characteristics in female patients with constipation of pelvic floor achalasia syndrome

目的应用盆底超声分析盆底失弛缓综合征便秘女性盆底肌运动特征,寻找可靠诊断指标。方法选取2017年1月至2019年7月于我院进行盆底超声检查的女性64例,分为盆底失迟缓综合征便秘组30例和非便秘组34例,分别于静息状态及Valsalva动作后测量肛提肌裂孔前后径、左右径、裂孔面积及肛直肠角角度,并动态观察肛提肌裂孔形态变化,分析Valsalva动作后肛提肌运动特征。结果与静息状态比较,盆底失弛缓综合征便秘组Valsalva动作后28例(93.33%)肛直肠角角度变小,20例(66.67%)肛提肌裂孔前后径变小,差异均有统计学意义(P<0.05)。非便秘组Valsalva动作后肛直肠角角度变化差异无统计学意义(P>0.05),肛提肌裂孔前后径变大,差异有统计学意义(P<0.001)。结论盆底超声检查能对女性盆底失弛缓综合征便秘患者盆底肌运动进行实时观察,肛直肠角角度变小以及肛提肌裂孔前后径变小为其运动特征。

Objective To analyze the characteristics of pelvic floor muscle movement in female with constipation of pelvic floor achalasia syndrome by using pelvic floor ultrasound and to search for reliable diagnostic indicators.Methods Sixty-four female patients underwent pelvic floor ultrasound examination in our hospital during January 2017 to July 2019 were involved in this study.The patients were divided into constipation group(n=30)and non-constipation group(n=34).The levator hiatus antero-posterior diameter,right and left diameter,and area and anorecal angle were measured by the pelvic floor ultrasound on resting and after Valsalva maneuver.The morphology of levator hiatus was observed dynamically.The movement characteristics of levator after Valsalva action were analyzed.Results In the constipation group,the anorecal angle of 28 patients(93.33%)became smaller and the levator hiatus antero-posterior diameter of 20 patients(66.67%)became smaller after the Valsalva action when compared to resting status(P<0.05).In the non-constipation group,there was no significant difference in the anorecal angle(P>0.05)but the levator hiatus antero-posterior diameter became bigger after the Valsalva action when compared to resting status(P<0.001).Conclusion Pelvic floor ultrasound can be used to reel-time observe the characteristics of pelvic floor muscle movement of female patients with constipation of pelvic floor achalasia syndrome.The characteristics are that the anorecal angle and the levator hiatus antero-posterior diameter become smaller after the Valsalva action.