彩色超声多普勒诊断子宫全切除术后盆底功能改变

The diagnosis of the postoperative pelvic floor function changes by color Doppler ultrasound of women after total hysterectomy

目的:探究经会阴盆底彩色超声多普勒对行子宫全切除术患者术后盆底功能改变的临床诊断效果。方法:选取2018年1月-2020年1月在本院接受子宫全切除术后≥3个月患者100例,其中术后盆底功能改变50例为改变组,功能正常50例为正常组;同期健康体检妇女50例为对照组。分别在改变组、正常组术后3个月及对照组体检时行经会阴部盆底彩色超声多普勒检查,比较静息及Valsalva时尿道倾斜角(UOA)、膀胱尿道后角(PUA)、膀胱颈距耻骨联合下缘距离(BNSD)、膀胱最低点距耻骨联合下缘距离(BLSD)、膀胱逼尿肌厚度(BDT)、肛直角距耻骨联合后下缘距离(ASD)等指标,计算膀胱颈下降值(BND)、尿道旋转角(URA)、膀胱颈旋转角度(BNRA)等。结果:静息与Valsalva时改变组患者UOA、PUA均高于正常组及对照组,且正常组高于对照组(P<0.05);改变组患者BNSD、BLSD、ASD均低于正常组及对照组,且正常组低于对照组(P<0.05)。改变组BDT测量值及BND、URA、BNRA计算值均高于正常组和对照组,且正常组患者BDT测量值及BND、URA、BNRA计算值均高于对照组(P<0.05)。结论:经会阴部盆底彩色超声多普勒能够为子宫全切除术后盆底功能改变提供量化评估依据。

Objective: To explore the clinical diagnostic value of by transperineal pelvic floor color Doppler ultrasound for the postoperative pelvic floor function changes of women after total hysterectomy. Methods: 100 women in ≥3 months after total hysterectomy were included as the research objects from January 2018 to January 2020. Among them, 50 women with postoperative pelvic floor function changes were in group A, and 50 women with normal pelvic floor function were in group B. And another 50 healthy women were selected in group C during the same period. The perineal pelvic floor of the women in the three groups was examined by color Doppler ultrasound. The values of urethral tilt Angle(UTA), posterior urethral Angle(PUA), bladder neck to lower margin of pubic symphysis distance(BNSD), bladder nadir to lower margin of pubic symphysis distance(BLSD), bladder detrusor thickness(BDT), angle and posterior lower margin of pubic symphysis distance(ASD) of the women at rest and valsalva of the women were compared among the three groups. The values of bladder neck descending value(BND), urethra rotation Angle(URA), and bladder neck rotation Angle(BNRA) of the women in the three groups were calculated. Results: The values of UOA and PUA at rest and valsalva of the women in group A were significant higher than those of the women in group B and C, and which of the women in group B were significant higher than those of the women in group C(P<0.05). The values of BNSD, BLSD and ASD of the women in group A were significant lower than those of the women in group B and C, and which of the women in group B were significant lower than those of the women in group C(P<0.05). The measured values of BDT and calculated values of BND, URA and BNRA of the women in group A were significant higher than those of the women in group B and C, and the measured values of BDT and calculated values of BND,URA and BNRA of the women in group B were significant higher than those of the women in group C(P<0.05).Conclusion:Transperineal pelvic floor color Doppler ultrasound can provide quantitative evaluated evidences for pelvic floor function changes of the women after total hysterectomy.