二维腔内超声筛查隐性肛门括约肌损伤的初步研究  

Preliminary Study of Screening Occult Anal Sphincter Injuries Using 2D Transvaginal Probe

作　　者：王慧芳[1] 郭娟[1] 杨秋红[1] 陈华[1] 陈秋香[1] 王诗雅[1] 陈梦华[1] 

机构地区：[1]深圳大学第一附属医院(深圳市第二人民医院)超声科,广东省深圳市518035

出　　处：《中国超声医学杂志》2016年第7期644-647,共4页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市科技研发资金项目(No.JCYJ20130401114604306)

摘　　要：目的应用二维腔内超声对隐性肛门括约肌损伤进行筛查并分析其超声表现,探讨二维腔内超声在筛查隐性肛门括约肌损伤中的应用价值。方法经阴道分娩且临床诊断无Ⅲ°或Ⅳ°会阴撕裂的初产妇552例,其中会阴侧切组353例,无会阴侧切组199例。应用二维腔内探头在肛管矢状面和横切面观察肛门内、外括约肌的连续性和完整性,对隐性肛门括约肌损伤进行筛查。结果筛查隐性肛门括约肌损伤5例,其中肛门外括约肌损伤1例,肛门外括约肌合并内括约肌损伤4例。两组隐性肛门括约肌损伤发生率分别约1.1%(会阴侧切组,4/353)、0.5%(无会阴侧切组,1/199)。结论二维腔内超声可提供有价值的肛管解剖信息,能够快速筛查出隐性肛门括约肌损伤,具有重要临床应用价值。Objective In this study we aim to use the 2D transvaginal probe for screening occult anal sphincter injuries and analyzing its sonographic features and discuss its clinical value.Methods 552 primiparas who went through vaginal delivery without laceration of perineum of three or four degree were included in this study.353 of them had been performed episiotomy and the rest（199 cases）were not,according to which the 2 groups were divided.The anal tube of each woman was examined through 2D transradial ultrasonography with the 2D transvaginal probe and both the sagittal and transectional planes of the anal tube could then be obtained.In this way we did the observation of the wholeness of its internal and external anal sphincters and also screening for occult anal sphincter injuries.Results 5 positive cases were screened out and 1 was diagnosed as the external anal sphincter injury and 4 were both the external and internal sphincter injuries.The incidence of anal sphincter injuries in two groups were 1.1%（4 in 353 of group with episiotomy）and 0.5%（1in 199 of group without episiotomy）.Conclusions 2Dtransradial ultrasonography with the transvaginal probe could provide valuable anatomic information about the anal tube,by which the operators may quickly screen out occult anal sphincter injury.And it clinically counts for much.

关 键 词：二维腔内超声 肛管 隐性肛门括约肌损伤 会阴撕裂 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.6[医药卫生—诊断学]