会阴超声检查女性肛直角探讨角度变化对慢性便秘的诊疗价值

Discuss the clinical value of angle change on chronic constipation via female anorectal angle transperineal sonography

目的:会阴超声检查女性肛直角,探讨角度变化对慢性便秘的诊疗价值。方法 :对有、无慢性便秘临床症状的女性分别57、106例,运用3~5MHz凸阵腹部探头经会阴超声观察后盆腔,静息、提肛状态及乏氏试验时分别测量肛直前、后角的大小。将正常组按年龄分>42y,≤42y两组,静息状态下比较肛直前角及后角的大小。结果:无慢性便秘组肛直前、后角在静息状态、提肛状态、乏氏试验时,肛直角均较慢性便秘组扩大。具有统计学差异意义(P<0.01);提肛状态时前、后角慢性便秘组较无慢性便秘组小,差异具有统计学意义(P<0.01)。乏氏试验时前角慢性便秘组较无慢性便秘组小,有统计学差异意义(P<0.01)。后角慢性便秘组较无慢性便秘组无统计学差异意义(P>0.05)。在静息状态下,按年龄比较,前角>42岁者较≤42岁者小,差异有统计学意义(P<0.01);后角>42岁者较≤42岁者差异无统计学意义(P>0.05)。结论 :盆底肌群的肌力变化及相互的协调性可通过经会阴实时超声观察肛直前、后角大小变化间接反应,并预估其功能的变化将导致有无便秘及肛门失禁。

Objecrive Discuss the clinical value of angle change on chronic constipation via female anorectal angle transperineal sonography.Method There are 57 and 106 females respectively based on the fact that whether they have the clinical symptoms of chronic constipation. Use 3 ~ 5 MHz convex array abdomen probe to observe the posterior pelvic cavity via perineal ultrasound, measuring the anterior angle and posterior angle of the anorect under quiescent condition, contracting anus state and Valsalva test. Divide the Normal Group into two groups based on the age: one is older than 42 years old and the other equals to or is younger than 42 years old. Compare the anterior angle and the posterior angle of the anorect under quiescent condition.Result Compared with the Chronic Constipation Group, the anterior angle and posterior angle of the anorect of the Group without chronic constipation are bigger under quiescent condition, contracting anus state and Valsalva test. The difference is of statistical significance(P < 0.01); under the contracting anus state, the nterior angle and posterior angle of the anorect of the Chronic Constipation Group are smaller than those of the Group without chronic constipation, and the difference is of statistical significance(P < 0.01). During Valsalva test, the anterior angle of the Chronic Constipation Group is smaller than that of the Group without chronic constipation, and the difference is of statistical significance(P < 0.01). The posterior angle of the Chronic Constipation Group is smaller than that of the Group without chronic constipation, without statistical significance(P > 0.05).In the resting state, anterior horn according to age, the people who is more than 42 years of old is smaller than the people who is less than or equal to 42 years of age,and the difference is of statistical significance(P < 0.01). There was no statistically significant between the woman over age 42 and the woman is less than or equal to 42 years of old.