经会阴超声评估前盆腔器官脱垂程度与临床盆腔器官脱垂定量分期的相关性研究

摘要

Objective To explore the clinical value of sonographic quantification of anterior compartment organ prolapse by observing the anterior compartment of postpartum women by transperineal ultrasonography,and to compare the sonogrpahic findings against the pelvic organ prolapse quantification (POP-Q).Methods Transperineal ultrasonography was performed in 67 postpartum primiparae who were diagnosed to have anterior compartment organ prolapse according to POP-Q examination.Taking a horizontal line at the inferior margin of symphysis pubis as reference,the movements of urethra and posterior wall of urinary bladder when patients performing maximum Valsa[va maneuver were studied,and the distance from the lowest point of the posterior wall of urinary bladder to the reference line was measured.The sonographic findings were compared against that of the POP-Q assessment.Results Transperineal ultrasonographic assessment of anterior compartment organ prolapse showed great correlation to POP-Q examination (r =0.70).The criteria of anterior compartment organ prolapsed evaluation by transperineal ultrasonography were:1) When the maxima[descent of the posterior wall of urinary bladder was still above the reference line,it was defined as I-degree;2) If the lowest point of the posterior wall fell below the reference line but still less than 2 cm,it was defined as Ⅱ degree.Conclusions Transperineal ultrasonography can be used to evaluate anterior compartment organ prolapse and it has high correlation to POP-Q examination.Transperineal ultrasonography is a more objective method of quantification of anterior compartment organ prolapse in clinical practice.%目的 应用经会阴超声观察产后女性前盆腔器官脱垂情况,并与临床盆腔器官脱垂定量分期法(POP-Q)评估进行比较分析,探讨超声量化评估前盆腔器官脱垂程度的临床应用价值.方法 对经临床POP-Q评估诊断为前盆腔脏器脱垂的67例初产妇行经会阴超声检查.以经耻骨联合下缘的水平线为参考线,在最大Valsaval动作时观察尿道和膀胱后壁的运动变化情况,测量膀胱后壁脱垂最下缘距参考线的距离,并将超声检查结果与临床POP-Q评估结果进行统计学对比分析.结果 经会阴超声对前盆腔器官脱垂的评估与临床POP-Q评估具有较好的相关性(r=0.70),经会阴超声对前盆腔器官脱垂程度的评估标准:Ⅰ度脱垂膀胱后壁脱垂最下缘位于参考线以上；Ⅱ度脱垂位于参考线以下2 cm以内.结论 经会阴超声能定量评估前盆腔器官脱垂的程度,与临床POP-Q评估相关性较好,可作为临床量化诊断前盆腔器官脱垂的影像学方法.