盆底二维超声评价前盆腔脏器脱垂的初步研究

目的 评价盆底二维超声技术诊断前盆腔脏器脱垂的临床价值,为临床实践提供指导.方法 以2015年4月至2016年12月来我院检查的120例育龄妇女为研究对象,根据患者生育情况及临床诊断结果,将患者分为正常未生育组、产后未脱垂组及产后脱垂组,每组40例.分别采用盆底二维超声技术对患者前盆腔器官脱垂程度进行影像学分析,分析前盆腔脏器脱垂患者盆底超声影像学特点,并将影像学分析结果与传统盆腔器官脱垂量化分期评价法进行比较,对不同方法在前盆腔脏器脱垂诊断方面的相关性.结果 产后脱垂组患者与正常未生育组及产后未脱垂组女性比较,膀胱颈与耻骨联合中轴线的夹角及膀胱颈下降度均明显升高,膀胱后壁与站立位垂直线夹角及膀胱颈距耻骨联合下缘距离均明显降低,差异均具有统计学意义(P<0.05),而正常未生育组与产后未脱垂组超声各项参数比较差异均无统计学意义(P>0.05);同时超声测量与传统盆腔器官脱垂量化分期评价法在评价前盆腔脏器脱垂方面具有良好的相关性,相关系数大于0.839.结论 盆底二维超声技术能够有效提供患者盆腔脏器的解剖结构,可用于盆腔脏器脱垂的程度的初步评价,该方法与传统盆腔器官脱垂量化评价系统相关性良好,可为盆腔脏器脱垂的诊断、手术方案的确定及预后评价提供可靠依据,值得临床推广使用.

Initial research of the pelvic organ prolapse by using two-dimensional pelvic floor ultrasonography

Objective To evaluate the clinical value of the two-dimensional pelvic floor ultrasonography in the diagnosis of the pelvic organ prolapse, and provide guidance for clinical practice. Methods A total of 120 women of childbearing age, who were checked in our hospital from April 2015 to December 2016, were divided into the nullipara group, the healthy puerpera group and the pelvic organ prolapse group according to the fertility condition and the clinical diagnosis, with 40 cases in each group. The ultrasonographical features of pelvic floor in patients with pelvic organ pro-lapse were analyzed by analyzing the degree of pelvic organ prolapse through two-dimensional pelvic floor ultrasonogra-phy. The diagnosis results of ultrasonographical imagining and traditional quantitative staging evaluation of pelvic organ prolapse were compared, and the correlation of different methods in the diagnosis of prolapse of the pelvic organ were analyzed. Results Compared with nullipara women and healthy puerpera women, the angle between the bladder neck and the pubic symphysis axis and the descending degree of the bladder neck were significantly increased, and the dis-tance between the posterior wall of the bladder and the standing vertical line and the distance between the bladder neck and the lower edge of the pubic symphysis were significantly decreased (P<0.05);but there were no statistically differ-ence between the nullipara group and healthy puerpera group (P>0.05). At the same time, ultrasound measurement had a good correlation with traditional quantitative staging evaluation method in the evaluation of pelvic organ prolapse, with the correlation coefficient greater than 0.839. Conclusion The two-dimensional pelvic floor ultrasonography can pro-vide the anatomical structure of the pelvic organs effectively, which can be used for the initial evaluation of pelvic organ prolapse. The two-dimensional pelvic floor ultrasonography has a good correlation with the traditional pelvic organ pro-lapse quantification method, which can provide a reliable basis for the diagnosis of pelvic organ prolapse, the determina-tion of surgical procedures and prognosis. It is worthy of clinical promotion.