断层超声评估肛提肌缺损的初步应用研究  

Primary application study of tomographic ultrasound in evaluation of levator defect

作　　者：庄蓉蓉[1] 江丽[2] 宋岩峰[1] 

机构地区：[1]福建医科大学福总临床医学院妇产科,福州市350003 [2]南京军区福州总医院超声诊断科

出　　处：《临床超声医学杂志》2011年第7期436-439,共4页Journal of Clinical Ultrasound in Medicine

基　　金：福建省重点项目(2010Y0046);福建省科技创新平台项目(2010Y2005)

摘　　要：目的通过三维超声结合断层超声技术观察盆腔器官脱垂(POP)患者肛提肌形态的改变。方法入选就诊我院门诊的54例POP患者(POP组)和35例排除POP的普通妇科疾病患者(对照组),采用经会阴三维超声检查获取受试者在静息及盆底肌收缩状态下的图像,将容积超声数据处理成断层超声图像,对照观察POP组和对照组间的肛提肌形态变化,分析两组间的肛提肌裂孔大小、肛提肌缺损情况。结果 89例患者中,有7例(5例POP组,2例对照组)经指导训练后仍无法完成缩肛动作,故退出本研究。三维超声技术可较好地呈现盆底的解剖结构,结合断层超声显像可判断肛提肌断裂。POP组肛提肌断裂率30.6%,明显高于对照组(9.1%),差异有统计学意义(P<0.05);POP患者中,肛提肌断裂患者在静息状态及盆底肌收缩状态下的肛提肌裂孔面积分别为(22.13±4.89)cm2、(19.10±4.23)cm2,矢状位裂孔长度分别为(6.01±1.04)cm、(4.93±0.60)cm,均大于肛提肌完整患者,且差异有统计学意义(P<0.05)。结论经会阴三维超声可较好地显示盆底的解剖结构,断层超声有助于判断肛提肌缺损。Objective To observe the morphological changes of levator ani in pelvic organ prolapse（POP） women by three - dimensional ultrasound combined with tomographic ultrasound. Methods Fifty - four patients with POP and 35 normal controls were enrolled in this study. All the subjects underwent transperineal three - dimensional ultrasonography, the images of the standard midsagittal field and volume datasets at rest and during contraction were acquired. The morphological changes of the levator ani between two groups were observed. The levator hiatus size and defect were analyzed in the two groups. Results In 89 patients, 7 cases quitted the study because of they couldn＇t finish the levator ani contraction after training. Three - dimensional ultrasound showed the anatomy structure of pelvic floor well, equivalent tomographic ultrasound imaging could quantify levator defect. The incidence of levator defect in POP group（ 30.6% ） was higher than that in control group （9.1% ）. The area of the levator hiatus at rest and contraction was （22.13 ± 4.89） cm^2 and （ 19.10 ±4.23） cm^2, respectively, the sagittal hiatal diameter was （6.01 ± 1.04） cm and （4.93 ± 0.60） cm, respectively. The area and the diameter in POP group were increased than those in control group, there was significant difference between two groups （ P 〈 0.05 ）. Conclusion Transperineal three - dimensional ultrasound can display the anatomy structure of pelvic floor well, and tomographic ultrasound can help to diagnose levator ani defect.

关 键 词：肛提肌 超声检查 三维 断层超声 盆底器官脱垂 

分 类 号：R711.2[医药卫生—妇产科学] R445.1[医药卫生—临床医学]