Objective:To explore the value of transperineal ultrasonography in detecting the levator ani muscle morphological changes of female with prolapse of uterus .Methods:72 female patients with uterine prolapse under-went transperineal three-dimensional ultrasound investigation .The morphological characteristics of pelvic diaphragm hiatus ,the perimeter and area of pelvic diaphragm hiatus were measured at rest ,on maximum pelvic floor contraction and maximum Valsalva by three-dimensional ultrasound ,respectively .Results:The perimeter and area of pelvic dia-phragm hiatus in patients with uterine prolapse were significantly increased than those in control group ,at rest ,on maximum pelvic floor contraction and maximum Valsalva respectively .The perimeter and area of pelvic diaphragm hiatus in patients with uterine prolapse were significantly biggest on maximum Valsalva ,but there was no significant difference between at rest and on maximum contraction .Conclusion :Both the contractile and diastolic functions of the patients with uterine prolapse decrease .The dynamic three-dimensional ultrasonography is an effective method for the determination of levator ani muscle in female patients with prolapse of uterus .%目的:应用盆底三维超声检查,观察子宫脱垂女性肛提肌裂孔的变化,探讨盆底肌群的解剖及功能改变与子宫脱垂的相关性.方法:经会阴三维超声对72例子宫脱垂女性进行三维盆底超声检查,三维重建处理后获得盆底横断面声像图,观察肛提肌裂孔在静息状态、缩肛动作和Valsalva动作三种状态的形态改变并测量肛提肌裂孔周长及面积,比较不同状态下肛提肌裂孔改变,并与对照组比较分析.结果:静息状态、缩肛动作及Valsalva动作后,子宫脱垂女性的肛提肌裂孔面积均较对照组增大(P<0.05),三种状态相比较,缩肛动作盆底整体向头腹侧移动,Valsalva动作盆底整体向背尾侧移动,Valsalva动作时肛提肌裂孔面积大于静息状态,也大于缩肛动作,静息状态与缩肛动作相比,差异无统计学意义(P>0.05).结论:子宫脱垂患者肌肉收缩与舒张功能均下降,经会阴盆底三维超声检查能评估子宫脱垂患者肛提肌裂孔的解剖及功能改变.
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