经会阴超声评估盆底康复治疗近期疗效  

Transperineal ultrasonographic evaluation of short-term effects of pelvic floor rehabilitation therapy

作　　者：陈华[1] 王慧芳[1] 陈梦华[1] 郭子平[2] 王瑾[1] 陈秋香[1] 郭娟[1] 王诗雅[1] 巫敏[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,广东深圳518035 [2]深圳大学第一附属医院深圳市第二人民医院产科,广东深圳518035

出　　处：《中国医学影像技术》2016年第8期1240-1243,共4页Chinese Journal of Medical Imaging Technology

基　　金：深圳市战略新兴产业发展专项资金项目(CXZZ20120830113520223)

摘　　要：目的 探讨经会阴超声评估盆底康复治疗近期疗效的临床价值。方法 对前盆腔器官脱垂或盆底肌力〈4级的50例初产妇行盆底康复治疗1个疗程（约6周）。对比治疗前后压力性尿失禁自主症状、前盆腔超声表现、盆底肌力的变化,并进行统计学分析。结果 与治疗前比较,压力性尿失禁自主症状者由12例（12/50,24.00%）减少至3例（3/50,6.00%,P〈0.05）;静息状态及最大瓦氏动作时膀胱颈位于经耻骨联合下缘参考线的位置升高;最大瓦氏动作时,Ⅱ~Ⅲ级前盆腔脏器脱垂者由46例（46/50,92.00%）减少为34例（34/50,68.00%,χ~2=11.97,P〈0.05）;双侧耻骨直肠肌厚度、耻骨直肠肌增厚率均增加（P均〈0.05）;Ⅰ类肌纤维肌力≥4级者由4例（4/50,8.00%）增加至24例（24/50,48.00%）,Ⅱ类肌纤维肌力≥4级者由9例（9/50,18.00%）增加至25例（25/50,50.00%）,差异均有统计学意义（P均〈0.05）。结论 经会阴超声在评估盆底康复治疗近期疗效中具有重要的临床价值。Objective To explore the clinical value of transperineal ultrasonography on evaluation of short-term effects of pelvic floor rehabilitation therapy. Methods A 6-week pelvic floor rehabilitation therapy was performed in 50 primiparaes with pelvic organ prolapse of anterior compartment or pelvic floor muscle strength〈level 4. The subjective symptoms of stress incontinence, sonographic features of anterior pelvic compartment and the change of the pelvic floor muscle strength were compared before and after pelvic floor rehabilitation therapy, and the statistical analysis was performed. Results Af- ter pelvic floor rehabilitation therapy, the amount of cases with symptoms of stress incontinence decreased from 12 （12/50, 24.00%） to 3 （3/50, 6.00%, P〈0.05）. The distance from bladder neck to the referece line of the inferior margin of sym- physis pubis decreased at themaximal Valsalva maneuver and resting. The cases with anterior compartment organ prolapse level Ⅱ-Ⅲ decreased from 46 （46/50, 92.00%） to 34 （34/50, 68.00%, X^2 =11.97, P〈0.05） at the maximal Valsalva maneuver. Both thickness and thickening rate of bilateral puborectalis increased （both P〈0.05）. The number of cases with type I muscle fiber strength≥level 4 increased from 4 （4/50, 8.00%） to 24 （24/50, 48.00%）, and the cases with type Ⅱ muscle fiber strength≥level 4 increased from 9 （9/50, 18. 00%） to 25 （25/50, 50.00%）. All the statistical differ- ences were significant （all P〈0. 05）. Conclusion Transperineal ultrasonography has an important clinical value on evalua- tion of short-term effects of pelvic floor rehabilitation therapy.

关 键 词：盆腔器官脱垂 盆底康复 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R323.34[医药卫生—诊断学]