三维超声在评估盆腔器官脱垂老年女性患者肛提肌收缩功能中的应用

摘要

目的：探讨三维超声评估盆腔器官脱垂老年女性患者肛提肌收缩功能的应用价值。方法选择2011年7月至2013年2月该院妇科收治的盆腔器官脱垂老年女性患者58例，患者均接受经会阴三维超声检查及张力强度评分（Oxford Scale）。采集患者三维图像及数据，计算出膀胱颈移动度（D）、肛提肌裂孔长度（L）、水平成角（R）及面积（S）的变化值等参数数值，并对肛提肌Oxford Scale与三维超声参数的相关性进行分析。结果肛提肌Oxford Scale 0分2例，1分3例，2分10例，3分18例，4分20例，5分5例。三维超声参数D、L、R及 S值分别为（7．46±2．15）mm、（9．05±3．27）mm、（9．55±5．24）°和（16．43±2．58）％。对肛提肌 Oxford Scale与三维超声参数的相关性作进一步分析发现，肛提肌 Oxford Scale 与 S 值相关性最好（rs＝0．77，P＜0．01），其次为 L（rs＝0．72，P＜0．01）、R（rs＝0．69，P＜0．01）、D（rs＝0．64，P＜0．01）。结论三维超声能够较为客观地评估盆腔器官脱垂老年女性患者的肛提肌收缩功能。%Objective To probe the application value of the three-dimensional ultrasound in the evaluation of levator ani muscle contractile function in elderly female patients with pelvic organ prolapse.Methods 58 elderly female patients with pelvic organ pro-lapse in the gynecology department of our hospital from July 2011 to February 2013 were selected and received the transperineal three-dimensional ultrasound examination.The intensity evaluation was performed by the Oxford Scale.The three-dimensional ima-ges and data were collected for calculating the parameter values of the bladder neck mobility (D),levator hiatus length (L),horizon-tal angle (R)and area (S)changes,etc.The correlation between the Oxford Scale intensity score of levator ani muscle and the three-dimensional ultrasound parameters were further analyzed.Results The intensity scores of levator ani muscle by the Oxford Scale were as follows:0 points in 2 cases,1 points in 3 cases,2 points in 10 cases,3 points in 18 cases,4 points in 20 cases,5 points in 5 cases.Three-dimensional ultrasound parameters D,L,R and S values were (7.46±2.15)mm,(9.05±3.27)mm,(9.55±5.24)° and (16.43±2.58)%.Further analysis showed that the intensity score of the levator ani muscle by the Oxford Scale got the best correlation with the S value (rs= 0.77,P<0.01),followed by L (rs= 0.72,P<0.01),R (rs= 0.69,P<0.01 )and D (rs=0.64,P<0.01).Conclusion Three-dimensional ultrasound could be a more objective way to assess the levator ani muscle contrac-tile function in elderly female patients with pelvic organ prolapse.