盆腔动态多重造影和盆腔四重造影检查在功能性排粪障碍诊断中的自身对照研究  

Self-control study of dynamic multiple pelvic angiography and pelvic four-contrast defecography in the diagnosis of functional defecation disorder

作　　者：龚文敬[1] 赵美珠[1] 钟恋[1] 黄辉经 安辉[1] 任叔阳[1] 蓝海波[1] 赵希忠[1] 杨向东[1] 

机构地区：[1]成都肛肠专科医院便秘科,610015

出　　处：《中华胃肠外科杂志》2016年第3期304-307,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的评价和比较盆腔动态多重造影和盆腔四重造影检查对功能性排粪障碍的诊断价值。方法2014年9月至2015年7月，成都肛肠专科医院便秘科前瞻性对符合功能性排粪障碍诊断标准的32例患者同时进行了盆腔动态多重造影和盆腔四重造影检查，总结分析并比较两种检查结果的差异。结果盆腔动态多重造影和盆腔四重造影从静息相到力排相各指标变化绝对值分别为：肛直角（29．6±13．6）°和（24．6±5．8）°（P=0．026），会阴位置（26．2±14．2）mm和（18．7±10．6）mm（P=0．022），盆底腹膜位置（55．5±25．6）mm和（34．5±18．4）mm（P=0．000），膀胱位置（28．9±16．5）mm和（19．2±11．8）mm（P=0．011）。盆腔动态多重造影对盆底腹膜疝的诊断率为93．8％（30／32），盆腔四重造影的诊断率则为68．8％（22／32），差异具有统计学意义（P=0．011）。结论盆腔动态多重造影检查在诊断盆底腹膜疝病变方面具有显著优势，可为功能性排粪障碍的病因诊断提供客观依据。Objective To evaluate and compare the value of dynamic multiple pelvic angiography and pelvic four-contrast defecography in the diagnosis of functional defecation disorder. Methods From September 2014 to July 2015, a prospective controlled trial was carried out in Chengdu Anorectal Hospital. A total of 32 patients met the inclusion criteria of functional defecation disorder simultaneously underwent pelvic four-contrast defecography and dynamic multiple pelvic angiography. The diagnostic results of these two methods were compared. Results The absolute values of anorectal angle and level of perineum, peritoneum and bladder from rest to defecation were （29.6 ± 13.6）° , （26.2± 14.2） mm, （55.5 ± 25.6） mm and （28.9± 16.5） mm in dynamic multiple pelvic angiography, and （24.6 ± 5.8）°, （18.7 ±10.6） mm, （34.5 ± 18.4） mm and （19.2 ± 11.8） mm in pelvic four-contrast defecography respectively, whose differences were statistically significant （P = 0.026, 0.022, 0.000, 0.011 respectively）. The diagnostic rate of pelvic peritoneal hernia was 93.8%（30/32） and 68.8%（22/32） in dynamic multiple pelvic angiography and pelvic four-contrast defecography respectively with significant difference （P=0.011）. Conclusion Dynamic multiple pelvic angiography has significant advantage in the diagnosis of pelvic peritoneal hernia, and can provide a more objective basis for the diagnosis of functional defecation disorder.

关 键 词：功能性排粪障碍 盆腔动态多重造影 盆腔四重造影 诊断 影像学 

分 类 号：R574.62[医药卫生—消化系统]