机构地区:[1]湖北省妇幼保健院超声科,湖北武汉430070
出 处:《中国妇幼保健》2021年第23期5570-5573,共4页Maternal and Child Health Care of China
基 金:湖北省卫生计生委面上项目(WJ2018H0140)。
摘 要:目的运用智能盆底三维超声经会阴动态观察和评估伴有膀胱后壁脱垂未孕女性的盆膈裂孔相关参数的变化情况。方法选取2019年1月—2020年6月在湖北省妇幼保健院体检的232例未孕女性为研究对象,所有研究对象均行常规二维盆底超声检查,选择其中61例无盆腔脏器脱垂的未孕女性为对照组,33例仅有膀胱后壁脱垂的未孕女性为研究组,利用腹部三维容积探头经会阴测量所有研究对象在静息状态和最大Valsalva状态下盆膈裂孔面积(LHA)和左右侧肛提肌尿道间隙(LUG),并进行统计学分析。结果静息状态下,全部检查者均能清晰显示盆膈裂孔图像,盆膈裂孔结构完整,左右侧对称,裂孔从前到后依次排列尿道、阴道及直肠。静息状态下,研究组患者L-LUG[(17.18±2.20)mm]、R-LUG[(17.46±2.24)mm]及LHA[(11.75±1.95)cm^(2)]与对照组[(16.84±2.29)mm、(17.01±2.41)mm、(11.54±2.11)cm^(2)]比较,差异均无统计学意义(t=0.69、0.88、0.47,均P>0.05)。最大Valsalva状态下,研究组患者L-LUG[(20.41±1.94)mm]、R-LUG[(18.27±2.38)mm]及LHA[(6.53±2.89)cm^(2)]均高于对照组[(18.13±2.16)mm、(16.53±2.89)mm、(13.48±3.04)cm^(2)],差异均有统计学意义(t=5.05、3.46、4.72,均P<0.05)。同组最大Valsalva状态时各参数均大于静息状态,差异均有统计学意义(均P<0.05)。结论经会阴三维盆底超声能够显示未孕女性静息状态和Valsalva状态下的盆膈裂孔形态和结构改变,伴膀胱后壁脱垂未孕女性在最大Valsalva状态时LAH和LUG均高于未脱垂女性,三维超声在未孕女性盆底功能障碍的评估诊断中具有重要作用。Objective To use dynamic three-dimensional pelvic floor ultrasound to observe and evaluate the changes of the related parameters of the pelvic diaphragm hiatus in non-pregnant women with posterior bladder prolapse.Methods Routine two-dimensional pelvic ultrasound examinations were performed on 232 non-pregnant women who came to the hospital for physical examination from January 2019 to June 2020. Among them, 61 non-pregnant women without pelvic organ prolapse were selected as the normal control group, 33 non-pregnant women with only posterior bladder prolapse as the research group, using the abdominal three-dimensional volumetric probe to measure the area of the pelvic diaphragm hiatus and the levator urethral gap of both sides in the resting and maximum valsalva state through perineum. All datas were analyzed statistically.Results Images of pelvic diaphragm hiatus were displayed clearly in all patients. The structure of the pelvic diaphragm hiatus was intact and both sides were symmetrical. The urethra, vagina and rectum were arranged sequentially from anterior to posterior. In the resting state, L-LUG [(17.18±2.20)mm], R-LUG [(17.46±2.24)mm] and LHA[(11.75±1.95)cm^(2)] in study group were compared with those in control group [(16.84±2.29)mm,(17.01±2.41)mm,(11.54±2.11)cm^(2)].The differences were not statistically significant(t=0.69,0.88,0.47,all P>0.05).Under the maximum Valsalva state, L-LUG [(20.41±1.94)mm],R-LUG [(18.27±2.38)mm] and LHA [(6.53±2.89)cm^(2)] in study group were higher than those in control group [(18.13±2.16)mm,(16.53±2.89)mm,(13.48±3.04)cm^(2)].The difference was statistically significant(t=5.05,3.46,4.72,P<0.05). In the same group, parameters were greater under the condition of valsalva maneuver compared to those under the condition of resting state, and the differences between the control group and the research group were statistically significant(P<0.05).Conclusion The transperineal three-dimensional pelvic floor ultrasound can show the morphological and structural changes of t
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