盆底超声对膀胱膨出的早期诊断价值及康复效果评估
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摘要
目的探讨经会阴盆底超声对膀胱膨出的早期诊断价值,并评估康复治疗的效果。方法选取我院2016年9月至2017年6月产后约6周经超声诊断为膀胱膨出并进行盆底康复治疗的20例患者为A组,选取20例膀胱膨出但未进行盆底康复治疗的患者为B组,选取20例产后1年以上已有压力性尿失禁症状并进行盆底康复治疗的患者为C组,于8周后分别对三组患者进行经会阴盆底超声检查,测量膀胱颈移动度及膀胱尿道后角。结果经盆底康复治疗后, A组的膀胱颈移动度和膀胱尿道后角明显优于B组(P <0.05)。A组的盆底康复治疗效果明显优于C组(P <0.05)。结论经会阴盆底超声可尽早诊断膀胱膨出,获得指导临床进行系统化盆底康复治疗的最佳时机,值得临床推广应用。
Objective To explore the value of transperineal pelvic floor ultrasound in early diagnosis of cystocele, and to evaluate the effect of rehabilitation therapy. Methods 20 cases of patients diagnosed as cystocele by ultrasound and undergoing pelvic floor rehabilitation therapy 6 weeks after delivery in our hospital from September 2016 to June 2017 were selected as group A. 20 cases of patients with cystocele but without pelvic floor rehabilitation therapy were selected as group B. 20 cases of patients with stress urinary incontinence and pelvic floor rehabilitation therapy more than one year after delivery were selected as group C. All the three groups received transperineal pelvic floor ultrasound 8 weeks later, and the mobile degree of bladder neck and posterior vesicourethral angle were detected. Results After pelvic floor rehabilitation therapy, the mobile degree of bladder neck and posterior vesicourethral angle of group A were significantly better than those of group B(P <0.05). The effect of pelvic floor rehabilitation therapy of group A was significantly better than that of group C(P<0.05). Conclusions Transperineal pelvic floor ultrasound can diagnose cystocele as early as possible and obtain the best timing to guide clinical systematic pelvic floor rehabilitation therapy, which is worthy of clinical promotion and application.
Objective To explore the value of transperineal pelvic floor ultrasound in early diagnosis of cystocele, and to evaluate the effect of rehabilitation therapy. Methods 20 cases of patients diagnosed as cystocele by ultrasound and undergoing pelvic floor rehabilitation therapy 6 weeks after delivery in our hospital from September 2016 to June 2017 were selected as group A. 20 cases of patients with cystocele but without pelvic floor rehabilitation therapy were selected as group B. 20 cases of patients with stress urinary incontinence and pelvic floor rehabilitation therapy more than one year after delivery were selected as group C. All the three groups received transperineal pelvic floor ultrasound 8 weeks later, and the mobile degree of bladder neck and posterior vesicourethral angle were detected. Results After pelvic floor rehabilitation therapy, the mobile degree of bladder neck and posterior vesicourethral angle of group A were significantly better than those of group B(P <0.05). The effect of pelvic floor rehabilitation therapy of group A was significantly better than that of group C(P<0.05). Conclusions Transperineal pelvic floor ultrasound can diagnose cystocele as early as possible and obtain the best timing to guide clinical systematic pelvic floor rehabilitation therapy, which is worthy of clinical promotion and application.
引文
[1]汪洋.分娩方式对盆底支持组织的影响分析[J].临床研究, 2016,24(5):54-55.
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[8]江丽,朱建平,叶培香,等.经会阴二维超声对压力性尿失禁女性患者盆底的动态观察与评估[J/CD].中华医学超声杂志(电子版),2012, 9(4):13-17.
[9] Memon HU, Blomquist JL, Dietz HP, et al. Comparison of levator ani muscle avulsion injury after forceps-assisted and vacuum-assisted vaginal childbirth[J]. Obstet Gynecol, 2015, 125(5):1080-1087.
[2] Green TH Jr. Urinary stress incontinence:differential diagnosis, pathophysiology, and management[J]. Am J Obstet Gynecol, 1975, 122(3):368-400.
[3] Dietz HP, Nazemian K, Shek KL, et al. Can urodynamic stress incontinence be diagnosed by ultrasound?[J]. Int Urogynecol J, 2013, 24(8):1399-1403.
[4]毛永江,黄泽萍,曹君妍,等.经会阴超声在女性膀胱膨出分型中的应用[J].中华超声影像学杂志, 2014, 23(8):694-696.
[5] Dietz HP, Haylen BT, Broome J. Ultrasound in the quantification of female pelvic organ prolapse[J]. Ultrasound Obstet Gynecol, 2001,18(5):511-514.
[6] Dwyer PL. Female pelvic floor dysfunction and estrogen therapy[J].Climacteric, 2001, 4(3):179-180.
[7]黄艳,李兆艾.女性压力性尿失禁的治疗进展[J].中国妇幼健康研究, 2016, 27(7):899-902.
[8]江丽,朱建平,叶培香,等.经会阴二维超声对压力性尿失禁女性患者盆底的动态观察与评估[J/CD].中华医学超声杂志(电子版),2012, 9(4):13-17.
[9] Memon HU, Blomquist JL, Dietz HP, et al. Comparison of levator ani muscle avulsion injury after forceps-assisted and vacuum-assisted vaginal childbirth[J]. Obstet Gynecol, 2015, 125(5):1080-1087.