经阴道二维腔内超声观察产后女性盆底耻骨直肠肌的临床价值

发布时间：2019-03-07 08:59

【摘要】：目的应用经阴道二维腔内超声观察经阴道分娩后女性耻骨直肠肌形态结构和收缩力度改变,判断耻骨直肠肌有无损伤,并与MRI进行比较分析,探讨经阴道二维腔内超声在观察耻骨直肠肌损伤中临床应用的可行性。方法回顾性分析在我院进行盆底超声检查的经阴道分娩后女性2 271例,分析经阴道二维腔内超声获取双侧耻骨直肠肌图像,观察耻骨直肠肌在静息和缩肛动作下的形态及收缩力度改变,诊断耻骨直肠肌损伤,总结出耻骨直肠肌完全性损伤后二维超声声像图改变,并与MRI进行比较分析,同时通过计算组内相关系数评估不同观察者间测量结果的一致性。结果经阴道二维腔内超声可以显示正常耻骨直肠肌形态及走行。2 271例经阴道分娩后女性中,经阴道二维腔内超声显示32例耻骨直肠肌完全性损伤:静息状态下,32例患者显示一侧或双侧耻骨直肠肌形态异常;缩肛动作下,31例患者显示一侧或双侧耻骨直肠肌形态及收缩力度异常,1例患者无法行有效缩肛动作。均经MRI证实。耻骨直肠肌部分性损伤:二维腔内超声诊断9例,MRI诊断14例。不同观察者在静息和缩肛动作下分析耻骨直肠肌具有很高的一致性,组内相关系数分别为0.87和0.81。结论经阴道二维腔内超声能观察耻骨直肠肌形态结构和收缩力度改变,判断耻骨直肠肌有无损伤,方法简便,重复性好,适于在临床推广应用。
[Abstract]:Objective to observe the morphological and contractile changes of female puborectum muscle after vaginal delivery by transvaginal two-dimensional intracavitary ultrasound (2-DE), and to evaluate the damage of puborectus muscle by transvaginal two-dimensional ultrasound and to compare it with MRI. To explore the feasibility of transvaginal two-dimensional intracavitary ultrasound in the observation of puborectal muscle injury. Methods the images of bilateral pubic rectus muscle obtained by transvaginal two-dimensional ultrasound were retrospectively analyzed in 2 271 women who underwent pelvic floor ultrasound examination in our hospital. The morphological and contractile changes of puborectus muscle under rest and anal contraction were observed, and the injury of puborectum muscle was diagnosed. The two-dimensional sonographic changes after complete injury of puborectum muscle were summarized and compared with those of MRI. At the same time, the consistency of measurement results between different observers was evaluated by calculating the intra-group correlation coefficient. Results Transvaginal two-dimensional ultrasound could show the shape and course of normal puborectum muscle. Among 2 271 women after vaginal delivery, 32 cases of complete puborectal muscle injury were demonstrated by transvaginal two-dimensional ultrasound: at rest, 32 cases showed abnormal morphology of one side or both sides of puborectal muscle. Under anal constriction, 31 patients showed abnormal shape and contractility of one or both sides of puborectal muscle, and one patient could not perform effective anal constriction. All of them were confirmed by MRI. Partial injury of pubic rectum muscle: 9 cases were diagnosed by two-dimensional intracavity ultrasound and 14 cases by MRI. The analysis of pubic rectus muscle by different observers at rest and anal contraction was highly consistent, with a correlation coefficient of 0.87 and 0.81 respectively. Conclusion Transvaginal two-dimensional intracavity ultrasound can observe the morphological structure and contractile intensity of puborectum muscle and judge the damage of puborectus muscle. The method is simple and reproducible, and it is suitable for clinical application.
【作者单位】：深圳大学第一附属医院深圳市第二人民医院超声科;
【基金】：基金项目:盆底超声智能定位及自动测量评级系统的研发和临床应用(No.201601027)
【分类号】：R445.1;R714

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