盆底超声诊断盆腔器官脱垂的临床分析

Clinical Analysis of Pelvic Floor Ultrasonography in Diagnosis of Pelvic Organ Prolapse

目的 探讨盆底超声诊断盆腔器官脱垂的临床效果。方法选择2020年6月—2022年4月南华大学附属南华医院收治的51例盆腔器官脱垂患者作为盆腔脱垂组,另选择同期在南华大学附属南华医院体检的51例非盆腔器官脱垂(健康者)受试者作为非脱垂组。两组受试者实施盆底二维及三维超声检查,对比分析两组二维、三维超声相关参数。结果 二维超声(Valsalva状态):盆腔脱垂组治疗前膀胱颈距离(31.25±3.25)mm、直肠壶腹部下降距离(20.43±2.75)mm、膀胱脱垂距离(16.58±2.89)mm、子宫脱垂距离(14.72±2.86)mm、直肠膨出距离(7.02±1.98)mm、膀胱尿道后角(144.25±15.01)mm,各直观分型相关指标均显著大于非脱垂组[(17.23±4.25)mm、(10.78±3.11)mm、(9.95±3.02)mm、(9.01±1.93)mm、(4.86±1.97)mm、(102.86±14.02)mm](P <0.05)。盆腔脱垂组治疗前三维超声静息状态、缩肛状态和Valsalva状态下肛提肌裂孔前后径、肛提肌裂孔面积、肛提肌裂孔横径和肛提肌角度均显著高于非脱垂组(P <0.05),盆腔脱垂组治疗后三维超声静息状态、缩肛状态和Valsalva状态下肛提肌裂孔前后径、肛提肌裂孔面积、肛提肌裂孔横径和肛提肌角度均显著小于治疗前(P <0.05)。结论 盆底超声检查可有效显示女性盆底结构状态,便于发现盆底结构异常,盆腔器官脱垂诊断价值较高,为盆底超声检查及盆底功能障碍性疾病诊断后期标准制定提供了一定借鉴内容。

Objective To investigate the clinical effect of pelvic floor ultrasonography in the diagnosis of Pelvic organ prolapse.Methods A total of 51 patients with pelvic organ prolapse who were admitted to Affiliated Nanhua Hospital,University of South China from June 2020 to April 2022 were selected as the pelvic prolapse group,and 51 non pelvic organ prolapse(healthy)subjects who were examined in Affiliated Nanhua Hospital,University of South China at the same time were selected as the non prolapse group.Two groups of subjects underwent pelvic floor two-dimensional and three-dimensional ultrasound examinations,and compared and analyzed the parameters related to two-dimensional and three-dimensional ultrasound between the two groups.Results Two dimensional ultrasound(Valsalva state):in the pelvic prolapse group,the distance of bladder neck before treatment(31.25±3.25)mm,the distance of rectal ampulla descending(20.43±2.75)mm,the distance of bladder prolapse(16.58±2.89)mm,the distance of Uterine prolapse(14.72±2.86)mm,the distance of rectal bulge(7.02±1.98)mm,and the posterior angle of bladder and urethra(144.25±15.01)mm,All visual classification related indicators were significantly higher than those in the non prolapse group[(17.23±4.25)mm,(10.78±3.11)mm,(9.95±3.02)mm,(9.01±1.93)mm,(4.86±1.97)mm,(102.86±14.02)mm](P<0.05).The anterior and posterior diameter,area,transverse diameter,and angle of the levator ani muscle hiatus in the pelvic prolapse group were significantly higher than those in the non prolapse group under three-dimensional ultrasound resting state,anal contraction state,and Valsalva state before treatment(P<0.05).After treatment,the three-dimensional ultrasound resting state,anal contraction state,and Valsalva state in the pelvic prolapse group showed significantly lower anterior and posterior diameters,area,transverse diameter,and angle of the levator ani muscle hiatus compared to before treatment(P<0.05).Conclusion Pelvic floor ultrasound can effectively show the structural state of female basins,which is convenient for finding structural abnormalities of the pelvic floor.Pelvic organ prolapse has high diagnostic value,which provides some reference for pelvic floor ultrasound and the establishment of late diagnostic criteria for pelvic floor dysfunction diseases.