直肠超声在诊断盆底腹膜疝中的应用效果和价值研究

Effect and Value of Rectal Ultrasound in Diagnosis of Pelvic Floor Peritoneal Hernia

目的探讨经直肠超声在诊断盆底腹膜疝中的应用效果和价值。方法选取2018年6月—2019年12月医院收治的经手术诊断为盆底腹膜疝患者,共25例,同时选取30名健康的成年人,手术前对患者进行直肠超声检查、会阴超声检查、X线盆腔造影检查,对三种超声的检测结果、经直肠超声的图像特征及手术结果情况进行观察;检查后为患者实施腹腔镜下微创手术治疗,对患者的手术结果情况进行观察。结果经直肠超声的正中矢状纵切面诊断显示,25例患者均存在盆底腹膜向下扩展深入到阴道后穹窿下方或膀胱颈水平的疝囊,当患者进行最大Valsalva动作时,22例患者的组织脏器均疝入直肠前陷窝的腹膜腔内,可对盆底腹膜疝进行准确的诊断,而其余3例未发现疝内容物,仅存在疝囊,未存在漏诊情况;经会阴超声检查后可知,16例患者的组织脏器均疝入直肠前陷窝的腹膜腔内,5例患者未发现疝内容物,有4例患者出现漏诊情况;经X线盆腔造影检查后可知,9例患者组织脏器疝均进入Douglas窝的腹膜腔内,10例患者未发现疝内容物,6例患者存在漏诊情况。对25例患者实施腹腔镜下微创手术与常规的修补后,其排便异常症状得到彻底改善,获得了较好的临床治疗效果。结论经直肠超声能够对盆底腹膜疝进行良好的诊断,并且能够对无疝内容物状态下的疝囊情况进行诊断。

Objective To investigate the effect and value of transrectal ultrasound in the diagnosis of pelvic floor peritoneal hernia.Methods 25 patients with pelvic floor peritoneal hernia were diagnosed by hand from June 2018 to December 2019,and 30 healthy adults were selected.Rectal ultrasound,perineal ultrasound and X line pelvic angiography were performed before operation.Results Positive transrectal ultrasound A midsagittal longitudinal section diagnosis showed that 25 patients had a hernia sac with pelvic floor peritoneum extending down to the posterior fornix of the vagina or the level of the bladder neck.When the maximum Valsalva action was performed,the tissue organs of 22 patients were hernia into the peritoneum of the anterior recess of the rectum,and the pelvic floor peritoneal hernia could be accurately diagnosed,while the remaining 3 patients had no hernia contents,only hernia sac,and no missed diagnosis.After perineal ultrasound examination,16 patients had tissue organs into the peritoneal cavity of the anterior recess of the rectum,5 patients had no hernia contents,and 4 patients had missed diagnosis;X pelvic examination After that,9 patients with tissue and organ hernia all entered the peritoneal cavity of Douglas fossa,10 patients did not find hernia contents,and 6 patients had missed diagnosis.After laparoscopic minimally invasive surgery and routine repair,the abnormal symptoms of defecation were completely improved and good clinical treatment was obtained.Conclusion Transrectal ultrasound can make a good diagnosis of pelvic floor peritoneal hernia and diagnose hernia sac without hernia contents.