三维超声对盆底结构改变所致排便障碍的机制研究  

3D-ultrasound in the Mechanism Research for Dyschesia Resulted from Pelvic Floor Structure Change

作　　者：孔凡娟[1,2] 孙洪军[1] 王志民[1] 张振[1] 林鸿[1] 王双垚 

机构地区：[1]山东省千佛山医院,山东济南250014 [2]山东中医药大学,山东济南250014

出　　处：《中国肛肠病杂志》2015年第10期46-48,共3页Chinese Journal of Coloproctology

基　　金：山东省自然科学基金项目（ZR2012HM086）

摘　　要：为评估三维超声对盆底结构的诊断价值，探讨耻骨直肠肌的厚度及耻骨直肠角的大小与排便障碍之间相关性，选取60例经产妇排便障碍患者（观察组）和60例健康已婚未育者（对照组），分别在静息期、Valsalva动作和缩肛动作时行盆底三维超声检查，并对三维重建声像图进行分析，测量耻骨直肠肌3、6、9点位的厚度和耻骨直肠角的大小。结果显示，对照组测得耻骨直肠肌3、6、9点位的厚度在静息期分别为（6．02±0．51）mm、（5．53±0．72）mm和（5．73±0．61）mm，Valsalva动作时为（5．71±0．32）mm、（5．33±0．21）mm和（5．43±0．23）mm，缩肛动作时为（6．53±0．31）mm、（5．98±0．42）mm和（6．18±0．50）mm；观察组测得耻骨直肠肌3、6、9点位的厚度在静息期分别为（5．72±0．49）mm、（4．11±0．48）mm和（5．21±0．67）mm，Valsalva动作时为（5．44±0．37）mm、（3．89±0．32）mm和（4．99±0．51）mm，缩肛动作时为（5．93±0．32）mm、（4．28±0．37）mm和（5．53±O．45）mm。对照组耻骨直肠角在静息期、Valsalva动作和缩肛动作3种不同状态下分别为（90．1±8．2）°、（99．5±7．8）°和（94．6±9．0）°；观察组分别为（74．6±9．8）°、（82．7±7．3）°和（79．3±8．7）°。与对照组相比，在静息期、Valsalva动作和缩肛动作3种不同状态下，观察组耻骨直肠肌均变薄，耻骨直肠角均变小，差异均有统计学意义，均P〈0．05。结果表明，三维超声能够很好地显示排便障碍患者盆底结构中耻骨直肠肌和耻骨直肠角的变化，反映耻骨直肠肌变薄和耻骨直肠角变小与排便障碍的相关性。Abstract This study was to assess the diagnostic value of 3D-ultrasound for pelvic floor structure,explore the relativity of dyschesia with the thickness of puborectal muscle and the size of puborectal angle,selected the 60 muhipara patients with dyschesia as observation group and 60 healthy volunteers who have married but not procreated yet as control group;then in rest stage, and during valsalva maneuver and shrinkage anal status performed 3D-ultrasound exam. to both groups and analyzed the obtained reconstructed sound image,and measured the thicknesses of puborectal muscle at 3,6,9 sites as well as the size of puborectal angle. As results, in control group the thickness at 3,6,9 sites in rest stage was 6.02±0.51,5.53±0.72,5.73±0.61（mm）; during valsalva maneuver was 5.71±0.32,5.33±0.21,5.43±0.23（mm）; during shrinkage anal status was 6.53±0.31,5.98±0.42,6.18±0.50（mm） ; while in observation group, respectively was 5.72±0. 49,4.11±0.48,5.21±0.67（mm）;valsalva maneuver was 5.44±0.37,3.89±0.32,4.99±0.51（mm）;during shrinkage anal was 5.93±0.32,4.28±0.37,5.53±0.45（mm）;in control group the size of puborectal angle was （90.1±8.2）°,（99.5±7.8）° and （94.6±9.0）° respectively in rest stage,during valsalva and shrinkag a- nal status;while in observation group,respectively was （74.6±9.8）°, （82.7±7.3）° and （79.3±8.7）°,compared both groups,in observation group the puborectal muscle significantly became thiner, the angle signif- icantly became less（ P〈0.05）.Results show that 3D-ultrasound can better display the change of puborectal puborectal muscle and angle in the pelvic floor of the dyschesia patients,i.e reflex the relativity of dys- ehesia with puborectal muscle becoming thiner and angle becoming less.

关 键 词：三维超声 盆底 耻骨直肠肌厚度 耻骨直肠角 排便障碍 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]