盆腔多重造影在成人出口梗阻型便秘诊断中的应用价值  

Applied value of multiple pelvic radiography in diagnosis of adult outlet obstructive constipation

作　　者：邓琪 吴宝林[1] 胡金香[1] Deng Qi;Wu Baolin;Hu Jinxiang(Department of Radiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院医学影像科,武汉430071

出　　处：《腹部外科》2018年第3期182-185,193,共5页Journal of Abdominal Surgery

摘　　要：目的评价盆腔多重造影在成人出口梗阻型便秘(outlet obstructive constipation,OOC)诊断中的应用价值。方法回顾性分析我院2012年10月至2017年4月之间135例[女性126例,男性9例,年龄为(58.2±11.5)岁]经罗马Ⅲ标准初诊为OOC且行盆腔多重造影病人的临床及影像资料,其中77例病人同时行盆腔造影、膀胱造影、阴道造影、排粪造影检查,39例病人行盆腔造影、阴道造影、排粪造影,19例病人行盆腔造影与排粪造影。结果 135例OOC病人均存在两种或两种以上盆底功能异常,其中盆底腹膜疝98例(直肠型80例,间隔型18例),膀胱脱垂59例,阴道脱垂46例,直肠前突伴黏膜脱垂101例(轻度29例,中度61例,重度11例),伴内套叠49例,直肠外脱垂8例,乙状结肠下垂62例,会阴下降106例,骶直分离6例和盆底痉挛综合征13例。结论盆腔多重造影较全面地反映盆底器官的动态变化,是全面、形象、客观、可靠的诊断OOC的方法。Objective To evaluate the diagnostic values of multiple pelvic radiography in adult outlet obstructive constipation（OOC）.Methods Between February 2008 and April 2017,the clinical and radiographic data of 135 patients（126 females and 9 males;mean age standard deviation,58.2±11.5）with OCC according to the ROME Ⅲ criterion undergoing multiple pelvic imaging were retrospectively analyzed.Seventy-seven cases were exmained by Pelviography＋urethrocystography＋colpography＋defecography,39 by pelviography＋colpography＋defecography,and 19 by pelviography＋defecography.Results There were two or more than two types of pelvic floor dysfunction in all the135 patients with OOC,including 98 cases of peritoneocele hernia（80 cases of rectal type and 18 cases of septal type）,59 cases of bladder prolapse,46 cases of coleoptosis,101 cases of rectocele combined with mucosal prolapse（29 mild cases,61 moderate cases and 11 severe cases）,49 cases of rectocele combined with intussusception,8 cases of external rectal mucosal prolapse,62 cases of sigmoid colonic drooping,106 cases of perineum descent,6 cases of sacral straight separation and 13 cases of spastic pelvic floor syndrome.Conclusions As a comprehensive,visual,objective and reliable diagnostic method,multiple pelvic radiography can reflect the dynamic changes of pelvic floor organs.It provides a comprehensive diagnostic information for clinicians.

关 键 词：慢性便秘 盆腔造影 盆底 

分 类 号：R256.35[医药卫生—中医内科学] R445.4[医药卫生—中医学]