出口梗阻性便秘病人的盆腔、阴道、膀胱及排粪同步造影  

SIMULTANEOUS PELVICOGRAPHY AND COLPOCYSTODEFECOGRAPHY IN PATIENTS WITH OUTLET OBSTRUCTIVE CONSTIPATION

作　　者：方仕文[1] 刘宝华[1] 张连阳[1] 张胜本[1] 龚水根[2] 

机构地区：[1]第三军医大学大坪医院普外科,重庆400042 [2]第三军医大学大坪医院放射科,重庆400042

出　　处：《大肠肛门病外科杂志》2001年第3期5-7,共3页Journal of Coloproctological Surgery

摘　　要：目的 :研究出口梗阻性便秘 (Outlet Obstructive Constipation,OOC)病人盆腔器官及盆底形态结构变化。方法 :对 38例出口梗阻性便秘病人及 12例正常对照者行盆腔、阴道、膀胱及排粪同步造影 (以下简称“四重造影”) ,包括盆腔造影 ,阴道涂以钡剂 ,结合排尿膀胱造影和排粪造影。测量肛直角、会阴位置、盆底腹膜位置、膀胱位置。结果 :四重造影诊断直肠内脱垂 37例 ,直肠前突 5例 ,盆底痉挛综合征 5例 ,而物理检查拟诊断分别为 12例 ,4例 ,1例 ,均 10 0 %得到造影检查证实。四重造影检查还发现盆底及腹膜疝 9例 ,膀胱脱出 6例 ,会阴下降综合征 3例 ,子宫后倒或脱垂 10例。与对照组相比 ,OOC组和排相肛直角增大 ,静息相及力排相会阴异常下降 ,力排相 Douglas陷凹加深 ;OOC组中有泌尿系症状者 ,静息相及力排相膀胱异常下降。结论 :四重造影诊断直肠内脱垂和直肠前突的阳性率明显高于临床物理诊断 ;而且对临床隐匿、物理检查难以诊断的盆底及腹膜疝、膀胱及子宫、阴道脱出等提供了形象客观的诊断依据 ,提高了诊断的准确性 。Objective:To research the form changes of pelvic floor and corresponding visceras in patients with outlet obstructive constipation (OOC) Methods: In the present study,we have used simultaneous pelvicography and colpocystodefecography (PCCD),including pelvicography,vaginal opacification,voiding cystography and defecography 38 patients with OCC and 12 healthy volunteers were studied Anorectal angle,the level of perineum,peritoneum and bladder were measured Results: 37 internal rectal prolapse (IRP),5 rectocele(RC) and 5 spastic pelvic floor syndrome (SPFS) were diagnosed by PCCD 12 IRP,4 RC,and 1 SPFS were detected by the common physical examination All of these were confirmed by PCCD Moreover,PCCD have found 9 pelvic floor hernia or peritoneoceles,6 cystoceles,3 descending perineum syndromes,10 uterine prolapses Compared with controls,OOC patients had a significantly large anorectal angle during defecation,abnormality descending of perineum at rest and defecation,and a deep pouch of Douglas dring defecation Some patients with urinary system symptoms may have an abnormality descent of bladder during rest and defecation Conclusion: PCCD has a higher positive ratio than the common physical examination in diagnosing IRP and RC,and provides information for diagnosis of pelvic floor hernia or peritoneocele,cystocele or uterine prolapse PCCD is helpful in the selection of a proper surgical procedure

关 键 词：出口梗阻性便秘 四重造影 盆底形态 诊断 盆腔 阴道 膀胱 排粪 OOC 

分 类 号：R656[医药卫生—外科学]