摘要
目的经会阴盆底超声动态观察围绝经期子宫切除术后盆底结构变化,并定量评估其近期盆底功能。方法选择2021年1月—2023年3月在徐州市妇幼保健院超声科因子宫良性病变行子宫全切术后1年内复查的62例患者作为观察者设为子宫切除组,年龄40~55岁,术前未绝经,术前无盆腔手术史,术前临床未诊断盆底功能障碍性疾病(pelvic floor dysfunction,PFD);选择同期在本院经会阴盆底超声检查前临床未诊断PFD的61名女性作为对照组,年龄40~54岁,未绝经,无盆腔手术史。所有检查者均由科室2名盆底研究方向副主任医师随机分配操作检查。所有受检者行经会阴盆底超声检查,在标准切面上测量膀胱逼尿肌厚度、静息状态及最大Valsalva状态下膀胱颈距离耻骨联合后下缘距离(X)、膀胱尿道后角(β)、直肠壶腹最低点距耻骨联合后下缘距离(D),观察尿道内口漏斗形成,计算尿道旋转角(Ra)及膀胱颈下降值(bladder neck descent,BND),并观察前后盆腔有无器官脱垂及程度。结果子宫切除组患者年龄较对照组大,有统计学意义(P<0.05),X、D值均减小,差异均有统计学意义(P<0.05);而Ra、β、BND、膀胱逼尿肌厚度及裂孔面积比较差异均无统计学意义(P>0.05);子宫切除组与对照组发生PFD的情况比较,仅直肠脱垂差异有统计学意义(P<0.05),压力性尿失禁(stress urinary incontinence,SUI)、膀胱脱垂、盆腔器官脱垂(pelvic organ prolapse,POP)总计及PFD总计比较差异均无统计学意义(P>0.05)。结论经会阴盆底超声可对围绝经期子宫切除术后盆底结构动态观察,并进行定量评估;子宫切除术对围绝经期女性后盆腔盆底功能影响较大。
Objective To dynamically observe changes in the pelvic floor structure following perimenopausal hysterectomy using transperineal pelvic floor ultrasound and to quantitatively assess the recent pelvic floor function.Methods A total of 62 patients who underwent hysterectomy due to benign uterine lesions in the ultrasound department of Xuzhou Maternal and Child Health Hospital from January 2021 to March 2023 and underwent follow-up within one year were selected as observe subjects,they were aged 40-55 years old,without menopause before surgery,without a history of pelvic surgery,and without clinical diagnosis of pelvic floor dysfunction disease before surgery.Another 61 females who were not clinically diagnosed with PFD prior to transperineal pelvic floor ultrasound examination in our hospital during the same period were selected as control group,they were aged 40-54 years old,without menopause and a history of pelvic surgery.All the patients were randomly assigned to undergo surgical examinations by two deputy chief physicians in the pelvic floor research direction of the department.All subjects underwent transperineal pelvic floor ultrasound examination.The thickness of bladder detrusor muscle,the distance from bladder neck to the posterior lower edge of pubic symphysis(X)under resting state and maximum Valsalva state,posterior vesicourethral angle(β),and the distance from the lowest point of the rectal ampulla to the posterior lower edge of the pubic symphysis(D),were measured on the standard section.The formation of the funnel at the internal urethral orifice was observed,and calculated the urethral rotation angle(Rα)and the bladder neck descent value(BND),and observed whether there was organ prolapse and its degree in the pelvic cavity before and after examination.Results The age of patients in the hysterectomy group was higher than that in the control group,it was statistically significant(P<0.05).The value of X and D were both reduced,and the differences were statistically significant(P<0.05).There were no
作者
林冲
许瑶璇
左云鹏
Lin Chong;Xu Yaoxuan;Zuo Yunpeng(Department of Ultrasound,Xuzhou Maternal and Child Health Hospital,Xuzhou,Jiangsu 221009,China)
出处
《齐齐哈尔医学院学报》
2024年第16期1568-1571,共4页
Journal of Qiqihar Medical University
基金
江苏省妇幼保健协会科研课题(FYX202211)。
关键词
会阴盆底超声
围绝经期
子宫切除术
盆底功能障碍性疾病
Pelvic floor ultrasound of perineum
Perimenopausal period
Hysterectomy
Pelvic floor dysfunction
