经会阴三维超声在广泛性子宫切除术后盆底形态学观察的应用研究

目的 利用三维超声观察广泛性子宫切除术患者术前及术后盆底形态的变化,评估其解剖结构的改变。方法：因子宫病变行广泛性子宫切除术患者,于术前1天及术后14天分别应用三维超声探头经会阴部扫查,重建盆底三维超声图像,观察肛提肌裂孔的结构和形态,并分别测量静息、Valsalva动作时肛提肌裂孔前后径、横径、面积以及肛提肌厚度。结果：广泛性子宫切除术后患者盆底解剖及结构发生改变,术后安静状态时肛提肌裂孔前后径、横径及面积,与术前安静状态时比较均增大,肛提肌厚度与术前安静状态时比较均减小,但差异无统计学意义(P＞0.05)；术前Valsalva动作时肛提肌裂孔前后径、横径及面积,与术前安静状态时比较均增大,差异有统计学意义(P＜0.05),肛提肌厚度与安静状态时比较略减小,差异无统计学意义(P＞0.05)；术后Valsalva动作时肛提肌裂孔前后径、横径及面积,与安静状态时比较均略增大,肛提肌厚度略减小,差异无统计学意义(P＞0.05)。结论：超声能够对广泛性子宫全切术后患者盆底形态学变化进行动态观察、 客观评价其解剖结构的变化。

Application of three dimensional ultrasound in pelvic floor morphology after extensive hysterectomy

OBJECTIVE: By the use of three-dimensional ultrasound in patients before and after radical hysterectomy surgery, in order to assess the changes of pelvic floor morphological and anatomy . METHODS: There were 45 cases had radical hysterectomy due to uterine lesion , and the parameters were measured in the preoperative one day and fourteen days after surgery by application of three-dimensional ultrasound through the perineum volume scanning, three-dimensional ultrasound image reconstruction, observed levator hiatus structure and anatomy, and the parameters including levator hiatus anteroposterior diameter, diameter, area, and levator ani muscle thickness during quiescent period and pressure period(when Valsalva breathing). RESULTS: The anatomy of the pelvic floor changed with patients after radical hysterectomy, the levator hiatus anteroposterior diameter, diameter, area were slightly increased and levator ani muscle thickness were slightly reduced during quiescent period, but the difference was not statistically significant (P> 0.05); compared the quiescent period, the levator hiatus anteroposterior diameter, diameter and area increased during Valsalva breathing with preoperative patients, the difference was statistically significant (P <0.05), levator ani muscle thickness were slightly reduced, but the difference was not statistically significant (P> 0.05); compared the quiescent period, the levator hiatus anteroposterior diameter, diameter and area increased during valsalva breathing with postoperative patients, levator ani muscle thickness were slightly reduced, and the difference was not statistically significant (P> 0.05).CONCLUSION: Ultrasound can be used to the hysterectomy surgery for morphological changes of the female pelvic floor dynamic observation, objective evaluation of changes in its anatomy.