摘要
目的 研究出口梗阻性便秘 (OOC)病人盆腔器官及盆底形态结构变化及其临床意义。方法 对 3 8例OOC病人及 12位健康自愿者 (对照组 )行盆腔、阴道、膀胱及排粪同步造影 (以下简称“四重造影”)。测量肛直角、会阴位置、盆底腹膜位置、膀胱位置。结果 四重造影诊断直肠内脱垂 3 7例 ,直肠前突 5例 ,盆底痉挛综合征5例。四重造影检查还发现盆底及腹膜疝 9例 ,膀胱脱出 6例 ,会阴下降综合征 3例 ,子宫后倾或脱垂 10例。与对照组相比 ,OOC组力排相肛直角增大 ,静息相及力排相会阴异常下降 ,力排相Douglas陷凹加深 ;OOC组中有泌尿系症状者 ,静息相及力排相膀胱异常下降。结论 四重造影诊断直肠内脱垂和直肠前突的阳性率较高 ,而且对临床隐匿、物理检查难以诊断的盆底及腹膜疝、膀胱及子宫异常、阴道脱出等疾病提供了形象客观的诊断依据 ,提高了诊断的准确性 ,有助于选择正确合理的治疗方式。
Objective To research the form changes of pelvic floor and corresponding visceras and clinical value in patients with outlet obstructive constipation (OOC). Methods In the present study,we used simultaneous pelvicography and colpocystodefecography (PCCD) to study 38 patients with OCC and 12 healthy volunteers.Anorectal angle,the level of perineum,peritoneum and bladder were measured.Results Thirty-seven cases of internal rectal prolapse (IRP),5 rectocele (RC) and 5 spastic pelvic floor syndrome (SPFS) were diagnosed by PCCD.All of these were confirmed by PCCD.Moreover,9 cases of pelvic floor hernia or peritoneoceles,6 cystoceles,3 descending perineum syndromes and 10 uterine prolapses were found by PCCD.Compared with controls,OOC patients had a significantly large anorectal angle during defecation,abnormality descending of perineum at rest and defecation,and a deep pouch of Douglas during defecation.Some patients with urinary system symptoms had an abnormality descent of bladder during rest and defecation.Conclusion PCCD has a higher positive ratio than the common physical examination in diagnosing IRP and RC,and provides information for diagnosis of clinical latent pelvic floor hernia or peritoneocele,cystocele or uterine prolapse.PCCD is helpful in the selection of a proper surgical procedure.
出处
《中国实用外科杂志》
CSCD
北大核心
2002年第12期722-724,共3页
Chinese Journal of Practical Surgery
基金
全军中青年人才培养基金资助
关键词
出口梗阻性便秘
盆底形态
同步造影
Outlet obstructive constipation Form of pelvic floor Simultaneous radiography
