经会阴超声在女性盆底功能障碍性疾病中的应用

目的 探讨经会阴超声在女性盆底功能障碍性疾病中的应用价值.方法 收集2012年10月～2013年2月在门诊、住院的病例103例（其中75例自然或选择性剖腹产后6～12周）.于患者自觉尿意时,取膀胱截石位,在静息状态下,经腔内、会阴常规检查盆腔脏器、盆底结构;测量并计算膀胱残余尿,计算公式：残余尿（ml）=X×Y×5.9-14.9（X、Y是两个彼此垂直的最大径,乘以常数5.9,减去常数14.9）.Valsalva动作后观察、采集图像,记录盆腔脏器脱垂及膀胱颈移动度情况,进行分析测量.结果 103例患者中,最大年龄76岁,最小20岁,平均30岁;产妇98例,其他5例,阳性80例,检出阳性率为78.0％（80/103例）;98例产妇中顺产56例,阳性52例,阳性率92.8％（52/56例）;剖腹产42例,阳性病例23例,阳性率54.8％（23/42例）;80例阳性病例中,单纯前、中、后盆腔膨出27例;膀胱膨出合并子宫脱垂42例;膀胱膨出合并直肠膨出1例;子宫脱垂合并直肠膨出1例;膀胱膨出合并子宫脱垂及直肠膨出9例.80例阳性患者中合并尿失禁23例,占29.0％（23/80例）.结论 经会阴超声在女性盆底功能障碍疾病诊断中具有较大的临床应用价值,尤其适宜在基层医院超声检查中推广应用.

The application of transperineal sonography in the female pelvic floor dysfunction

Objective To investigate the perineum ultrasound in application of female pelvic floor dysfunction. Methods This study collected 103 cases of hospital and clinic service patients including 75 cases of natural birth or selec- tive cesarean section in 6 to 12 weeks. When patients urge to urinate, take a bladder lithotomic position in the resting state, and take the routine examination of pelvic viscera and pelvic floor structure through cavity and perineum; Measuring and calculating bladder residual urine in reference formula：X ＊ Y ＊ 5.9-14.9 = residual urine （ml） （X, Y is the two vertical maximum diameter, multiplied by the constant 5.9, minus the constant 14.9）. After movement of Valsalva, the situation of Pelvic Organ Prolaps and mobility of vesical cervix were observed. Results The largest age of 103 cases was 76 years old, smallest was 20 years old and average was 30 years old. 80 cases （78%） were positive. 98 cases of pregnant eutocia were 56 patients. The positive rate was 92.8%. Cesarean section is 42 cases, 23 cases pasitive, 54. 8% of posi- tive rate （23/42）; 80 cases are positive, 27 cases of Pelvic Organ Prolapse are simple before, during and after 42 cases are cystoceIe merged with the uterine prolapse. One case is cystocele merged with the rectocele. One case is uterine pro- lapse combined with rectocele. 9 cases are cystocele merged with uterine prolapse and reetocele. Z3 cases in 80 cases are urinary incontinence merged, accounting for 29% （23/80）. Conclusion The perineum ultrasound in female pelvic floor dysfunction has a great application value. This paper aims to promote communications, improve the pelvic ultrasound in basic-level hospital and/earn from each other.