实时三维超声在子宫脱垂患者术前及术后随访的价值

Value of pelvic floor real-time three-dimensional ultrasound in preoperative and postoperative follow-up of patients with uterine prolapse

目的盆底实时三维超声定量分析不同盆底手术对子宫脱垂患者术后疗效,为子宫脱垂患者手术方式的选择提供新的思路和依据。方法依据不同手术方式将子宫脱垂患者135例随机分为3组,在术前及术后1,3,6个月分别对3组患者进行盆底实时三维超声检测,测量不同时间阴道顶端与耻骨联合下缘之间的距离(VVD)、阴道气样线长度(VGL)、肛提肌裂孔面积(ALH)等指标,并分别比较3组术后的复发情况。结果A,B,C 3组患者术前及术后VVD,VGL,ALH总体差异均有统计学意义(P<0.01)。手术后3个月与手术后6个月比较,A组VVD,VGL差异均有统计学意义(P<0.01);B组VGL差异有统计学意义(P<0.01);C组3项指标差异均无统计学意义(P>0.05)。术后6个月,C组复发率均低于A,B组(P=0.009,P=0.035)。结论高位子宫骶韧带合并圆韧带悬吊术手术复发率低,稳定性好;盆底实时三维超声可以定量评估子宫脱垂手术疗效。

Objective Quantitative analysis of postoperative quality of patients withuterine prolapsee by transperineal four-dimensional ultrasound.It provides a new idea and basis for the choice of surgi cal methods for patients with uterine prolapse.Methods Divided 135 patients suffered uterine prolapse into 3 groups according to the different surgical procedure,transperineal three-dimensional ultrasound examination was performed before and 1,3 and 6 months after operation for the three groups of subjects respectively.Distans between top of vaginal and lower edge of pubicsympfysis(VVD),vaginal gas line(VGL)and area of the levator hiatus(ALH)before and after operation were measured and compared.The recurrence rates of the three groups were compared.Results The overall differences of VVD,VGL and ALH before and after operation were statistically significant(P<0.01).Compared with 3 months after operation and 6 months after operation,the differences of VVD and VGL in group A were statistically significant(P<0.01);The difference of VGL in group B was statistically significant(P<0.01).The 3 indexes in group C was no statistically significant.At 6 months after operation,the recurrence rate in group C was lower than that in group A and group B(P=0.009 and 0.035).Conclusion Highuterosaral ligament suspension and round ligament suspension Is the recurrence rate is lower,the stability is better operation way.Pelvic floor three dimensional ultrasound can quantitatively and qualitatively evaluate the effect of uterine prolapse surgery.