经会阴三维超声检查在盆底功能障碍性疾病诊断及疗效评估中的价值  

Value of transperineal three-dimensional ultrasound in the diagnosis and treatment evaluation of pelvic floor dysfunction diseases

作　　者：熊萍 熊健莉 张洁 罗玉倩 杨秀琴 罗莉[2] 王辉[3] Xiong Ping;Xiong Jianli;Zhang Jie;Luo Yuqian;Yang Xiuqin;Luo Li;Wang Hui(Special Examination Department,Chongqing Qijiang Hospital of Traditional Chinese Medicine,Chongqing 401420,China;Department of Ultrasound Medicine,Qijiang District People's Hospital,Chongqing 401420,China;Department of Gynecology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China)

机构地区：[1]重庆市綦江区中医院特检科,重庆401420 [2]重庆市綦江区人民医院超声医学科,重庆401420 [3]重庆医科大学附属第一医院妇科,重庆400042

出　　处：《保健医学研究与实践》2024年第9期78-82,共5页Health Medicine Research and Practice

基　　金：重庆市綦江区科技计划项目(2020051)。

摘　　要：目的分析经会阴三维超声检查对盆底功能障碍性疾病(PFD)诊断及疗效评估的价值,以期为临床决策的制定提供参考。方法选取2021年3月—2022年12月于重庆市某医院进行治疗的64例PFD患者为PFD组,选取同时期无PFD病史的健康体检女性65例作为对照组。采用经会阴三维超声检查2组研究对象不同状态下盆膈裂孔前后径、横径、面积以及肛提肌厚度,采用经会阴三维超声检查PFD组患者治疗前后盆腔结构功能康复情况,比较经会阴二维、三维超声对PFD的诊断效能。结果PFD组患者静息、张力(Valsalva动作)以及缩肛状态的盆膈裂孔前后径、横径及面积均大于对照组,肛提肌厚度小于对照组(P<0.05)。治疗后,PFD组患者的子宫颈下降距离、膀胱颈下降距离以及尿道旋转角均小于治疗前,差异均有统计学意义(P<0.05)。经会阴二维超声诊断PFD的灵敏度、特异度、准确率分别为73.44%、52.31%、62.79%,经会阴三维超声诊断的灵敏度、特异度、准确率分别为92.19%、95.38%、93.80%,经会阴三维超声诊断PFD的灵敏度、特异度、准确率均高于经会阴二维超声(P<0.05)。结论在PFD的诊断与疗效评估中,经会阴三维超声比二维超声更具优势。三维超声可更准确显示盆底结构,其立体图像避免了二维超声的成像局限,在细节和测量准确性上更优,是临床PFD诊断和疗效评估的重要手段,值得临床推广。Objective To analyze the value of transperineal three-dimensional ultrasound in the diagnosis and treatment evaluation of pelvic floor dysfunction(PFD)diseases,with the aim of providing a reference for clinical decision-making.Methods A total of 64 patients with PFD treated at a hospital in Chongqing from March 2021 to December 2022 were selected as the PFD group,while 65 healthy women without a PFD history who underwent health check-ups during the same period were selected as the control group.Transperineal three-dimensional ultrasound was used to examine the anteroposterior diameter,transverse diameter,area of the pelvic diaphragm hiatus,and levator ani muscle thickness in both groups under different states.The pre-and post-treatment pelvic structural and functional recovery in the PFD group was assessed.The diagnostic efficacy of transperineal two-dimensional and three-dimensional ultrasound for PFD was compared.Results In the PFD group,the anteroposterior diameter,transverse diameter,and area of the pelvic diaphragm hiatus in resting,Valsalva maneuver,and anal contraction states were all significantly larger than those in the control group,while the levator ani muscle thickness was significantly smaller than that in the control group(P<0.05).After treatment,the cervical descent distance,bladder neck descent distance,and urethral rotation angle in the PFD group were all significantly smaller than those before treatment(P<0.05).The sensitivity,specificity,and accuracy of transperineal two-dimensional ultrasound in diagnosing PFD were 73.44%,52.31%,and 62.79%,respectively,while the sensitivity,specificity,and accuracy of transperineal three-dimensional ultrasound were 92.19%,95.38%,and 93.80%,respectively.The sensitivity,specificity,and accuracy of three-dimensional ultrasound for diagnosing PFD were all significantly higher than those of two-dimensional ultrasound(P<0.05).Conclusion Transperineal three-dimensional ultrasound is superior to two-dimensional ultrasound in the diagnosis and treatment evaluation of

关 键 词：经会阴三维超声 盆底功能障碍 疾病诊断 治疗评估 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.5[医药卫生—诊断学]