经会阴三维超声评估子宫全切术后患者盆底功能

Evaluation of pelvic floor function in patients with total hysterectomy by transperineal three-dimensional ultrasonography

目的应用经会阴三维超声评估子宫全切术后患者盆底功能的改变。方法选取在我院行子宫全切术的患者100例,均于术前1 d和术后1个月、3个月、6个月应用经会阴三维超声测量静息及最大Valsalva状态下膀胱颈距耻骨联合下缘的垂直距离(BSD和V-BSD)、膀胱尿道后角(R-UJV和V-UJV),计算膀胱颈移动度(BND)、尿道旋转角(UR),记录Valsalva状态下肛提肌最大裂孔面积,比较不同时期各参数变化。结果术前1 d与术后1个月各参数比较差异均无统计学意义;术前1 d、术后1个月与术后3、6个月比较,R-BSD、R-UJV差异均无统计学意义,V-BSD、V-UJV、BND、UR及肛提肌最大裂孔面积比较差异均有统计学意义(均P<0.05);术后3个月与术后6个月各参数比较差异均无统计学意义。结论子宫全切术后患者1个月内盆底功能受损不明显,3个月后盆底功能开始受损,且缓慢进展;经会阴三维超声可准确评估子宫全切术后患者盆底功能。

ObjectiveTo evaluate the changes of pelvic floor function in patients with total hysterectomy by transperineal three-dimensional ultrasonography.MethodsOne hundred patients who underwent total hysterectomy in our hospital were selected.The bladder neck to the edge of pubic symphysis vertical distance(BSD/V-BSD)and bladder urethra after angle(R-UJV/V-UJV)were measured at rest and maximum Valsalva 1 d before operation,1 month,3 months and 6 months after operation by transperineal three-dimensional ultrasonography.The bladder neck movement(BND)and urethral rotation angle(UR)were calculated,and the maximum hiatus area of levator ani muscle was recorded under Valsalva condition,and the changes of various parameters at different periods were compared.ResultsThere were no significant difference between the parameters of preoperative 1 d and 1 month after surgery.Compared with 3 and 6 months after surgery,the differences of R-BSD and R-UJV were not statistically significant in preoperative 1 d and 1 month after surgery,while the differences of V-BSD,V-UJV,BND,UR and the maximum hiatus area of levator ani muscle were statistically significant(all P<0.05).There were no significant difference between the parameters of 3 months and 6 months after surgery.ConclusionThe pelvic floor function of the patients is not significantly damaged within 1 month after total hysterectomy,but it began to be damaged at 3 months and then progressed slowly.Transperineal three-dimensional ultrasonography can accurately assess the pelvic floor function of patients after total hysterectomy.