经会阴二维超声观察未育女性前盆腔

目的采用腔内探头经会阴二维超声观察年轻未育女性前盆腔。方法对60例年轻未育女性,以耻骨联合下缘为参考点,分别在安静状态下、最大Valsaval动作时观察尿道和膀胱的运动变化,测量膀胱颈距耻骨联合下缘的垂直距离(BSD)和膀胱尿道后角,计算膀胱颈下降度(BND),并通过计算组内相关系数评估不同观察者间各数据结果的一致性。结果盆底正中矢状切面由腹侧至背侧依次显示耻骨联合、耻骨后间隙、尿道、膀胱颈、膀胱后壁。正常年轻未育女性在安静状态下BSD为(26.20±3.49)mm,膀胱尿道后角为(107.54±13.68)°;最大Valsaval动作时BSD为(14.05±4.32)mm,膀胱尿道后角为(110.97±14.96)°;BND为(12.74±4.48)mm。不同观察者测量安静状态下和最大Valsaval动作时BSD及计算BND的一致性非常好,组内相关系数分别为0.90、0.91和0.87。结论应用腔内探头经会阴二维超声可动态观察女性前盆腔器官的运动变化,方法简单,重复性和可比性好,值得推广。

Perineal two-dimensional ultrasound in observation on female anterior pelvic floor in young nulliparous women

Objective To observe the anterior pelvic floor of young nulliparous women with perineal two-dimensional ultrasound. Methods Taking the inferior margin of public symphysis as the reference plane, the shape and motion of the urethra and bladder were observed at rest and on Valsaval's maneuver in 60 young nulliparous women. Bladder neck-symphyseal distance (BSD) and retrovesical angle were measured, and the bladder neck descent (BND) was calculated. Interclass correlation coefficients were calculated to evaluate the consistency of the data. Results The public symphysis, the retropubic space, urethra, bladder neck and bladder wall showed from ventral to dorsal side in the midsagital plane of the pelvic floor. At rest, BSD was (26.20±3.49)mm, the retrovesical angle was (107.54±13.68)°, while on Valsaval's maneuver was (14.05±4.32)mm and (110.97±14.96)°, respectively. BND was (12.74±4.48)mm. The consistency was very high in measuring BNS at rest and on Valsaval's maneuver and BND for different observer. The interclass coefficient was 0.90, 0.91 and 0.87, respectively. Conclusion Two dimensional transperineal ultrasonography using vaginal probe can reveal the position and function of female anterior pelvic floor dynamically. It is simple and reproducible, worthy of clinical promotion.