| 林芸,钟春燕,唐静,魏俊,张晓航,冉素真.经会阴实时三维超声评估不同术式治疗中盆腔脱垂疗效[J].中国医学影像技术,2019,35(9):1375~1378 |
| 经会阴实时三维超声评估不同术式治疗中盆腔脱垂疗效 |
| Real-time three-dimensional perineal ultrasound in evaluation on curative effect of different surgical methods in patients with middle compartment pelvic floor prolapse |
| 投稿时间：2019-02-01 修订日期：2019-07-09 |
| DOI：10.13929/j.1003-3289.201902004 |
| 中文关键词: 盆腔 脱垂 外科手术 超声检查 |
| 英文关键词:pelvic prolapse surgical procedures ultrasonography |
| 基金项目:重庆市卫生计生委医学科研计划重点项目（2012-1-076）。 |
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| 中文摘要: |
| 目的 探讨经会阴实时三维超声定量分析评价经阴道单侧骶棘韧带悬吊术、双侧骶棘韧带悬吊术及采用网片的双侧骶棘韧带吊带固定术治疗重度中盆腔器官脱垂效果的价值。方法 回顾性分析96例接受手术治疗的中盆腔脱垂Ⅲ度及以上患者，根据术式分为经阴道单侧骶棘韧带悬吊术组（A组，n=23）、双侧骶棘韧带悬吊术组（B组，n=34）和采用网片的双侧骶棘韧带吊带固定术组（C组，n=39）。于术后1、3、6个月以经会阴实时三维超声测量宫颈外口最低点距耻骨联合后下缘距离（CVD）和肛提肌裂孔面积（ALH），计算并比较术后6个月复发率。结果 A组术后3、6个月CVD较术后1个月减低（P=0.005、0.012）；术后6个月ALH较术后3个月增加（P=0.002）。B组术后6个月CVD、ALH与术后3个月差异有统计学意义（P=0.014、0.007）。C组术后6个月ALH与术后1个月差异有统计学意义（P=0.009）。术后6个月，A、B、C组的复发率分别为13.04%（3/23）、8.82%（3/34）和2.56%（1/39），C组低于A和B组（P均<0.017）。结论 采用网片的双侧骶棘韧带吊带固定术治疗中盆腔脱垂术后稳定性好、复发率低；经会阴实时三维超声可直观、准确评估手术疗效。 |
| 英文摘要: |
| Objective To explore the value of real-time three-dimentional perineal ultrasound for quantitative analyzing clinical effect of unilateral sacrospinous ligament suspension, bilateral sacrospinous ligament suspension and bilateral sacrospinous ligament suspension using meshes in treatment of severe middle compartment pelvic floor prolapse. Methods Data of 96 patients with Ⅲ or higher degree middle compartment pelvic floor prolapse who underwent surgeries were analyzed retrospectively. The patients were divided into 3 groups according to different surgeries, including unilateral sacrospinous ligament suspension group (group A, n=23), bilateral sacrospinous ligament suspension group (group B, n=34) and bilateral sacrospinous ligament suspension using meshes group (group C, n=39). At 1, 3 and 6 months after operation, the distance between lowest point of cervical external orifice and lower edge of pubic symphysis (CVD) and the area of levator ani hiatus (ALH) were measured with real-time three-dimensional perineal ultrasound. The recurrence rate 6 months after operation was calculated and compared. Results In group A, CVD at 3 and 6 months after surgery were lower than that 1 month after surgery (P=0.005, 0.012), while ALH 6 months after surgery was higher than that 3 months after surgery (P=0.002). In group B, CVD and ALH were significant different between 6 months and 3 months after surgery (P=0.014, 0.007). In group C, ALH were significant different between 6 months and 1 month after surgery (P=0.009). Six months after surgical operation, the recurrence rate of middle compartment pelvic floor prolapse in group A, B and C was 13.04% (3/23), 8.82% (3/34) and 2.56% (1/39), respectively, in group C was lower than in group A and B (both P<0.017). Conclusion Bilateral sacrospinous ligament suspension using meshes is a minimal invasive surgery with better curative effect and lower recurrence rate for treatment of middle compartment pelvic floor prolapse. Real-time three-dimensional perineal ultrasound can directly and accurately evaluate curative effect of surgical operation of middle compartment pelvic floor prolapse. |
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