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中南大学湘雅医学院附属海口医院
纸质出版日期:2021,
网络出版日期:2021-8-26,
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符叶柳, 张植兰. 经会阴三维超声对子宫全切术后患者盆底功能的评估[J]. 临床超声医学杂志, 2021,23(8).
Evaluation of pelvic floor function in patients with total hysterectomy by transperineal three-dimensional ultrasonography[J]. Journal of Clinical Ultrasound in Medicine, 2021,23(8).
目的 应用经会阴三维超声来评估子宫全切术对患者盆底功能的影响。 方法 应用经会阴三维盆底超声动态观察子宫全切术患者术前1天、术后1个月、3个月、6个月盆底结构的变化情况
每次分别在静息及最大Valsalva状态下测量膀胱颈距耻骨联合下缘的垂直距离(R-BSD/V-BSD)、膀胱尿道后角(R-UJV/V-UJV)
计算膀胱颈移动度(BND)、尿道旋转角(UR)
记录最大Valsalva状态下肛提肌最大裂孔面积
将不同时期的各参数分别进行对比分析。 结果 术前1天与术后1个月对比
各参数间差异均无统计学意义(p>0.05);术前1天与术后3个月及6个月相比
R-BSD、R-UJV间差异均无统计学意义(p>0.05)
V-BSD、V-UJV、BND、UR及肛提肌最大裂孔面积间差异均具有统计学意义(p<0.05);术后1个月与术后3个月及6个月相比
R-BSD、R-UJV间差异均无统计学意义(p>0.05)
V-BSD、V-UJV、BND、UR及肛提肌最大裂孔面积间差异均具有统计学意义(p<0.05);术后3个月与术后6个月对比
各参数间差异均无统计学意义(p>0.05)。 结论 子宫全切术后患者1个月之内
盆底功能损伤不明显
3个月开始
盆底功能开始受损
此后缓慢进展;经会阴盆底超声可准确评估子宫全切术后患者的盆底功能
建议子宫全切术的患者术后1到3个月之间就开始进行盆底康复训练。
Objective To evaluate the effect of pelvic floor function on total hysterectomy patients by transperineal three-dimensional ultrasonography. Methods Used by the transperineal three-dimensional ultrasonography to dynamic observe the changes of the pelvic floor’s structure in total hysterectomy patients in preoperative 1 day
after 1 month
3 months
6 months . Each time measurement of bladder neck to the edge of pubic symphysis vertical distance (R - BSD/V - BSD) and bladder urethra after Angle (R - UJV/V - UJV)in resting and maximum Valsalva condition respectively
calculate the bladder neck movement (BND)
urethra rotation Angle (UR)
record the biggest anal levator hiatal area in maximum Valsalva condition
then analyze the various parameters of different periods respectively. Results There was no significant difference between the parameters of preoperative 1 day and 1 month after surgery (p>0.05).The differences between R - BSD and R - UJV were not statistically significant in preoperative 1 day and 3 or 6 months after surgery (p>0.05)
while the differences between V - BSD
V - UJV
BND
UR and the biggest anal levator hiatal area were statistically significant (p<0.05).Compared with 1 months and 3 or 6 months after the operation
there were no statistically significant differences between R - BSD and R - UJV (p>0.05)
while there were statistically significant differences between V - BSD
V - UJV
BND
UR and the biggest anal levator hiatal area (p<0.05).Compared with 3 and 6 months after surgery
there were no statistically significant differences among all parameters (p>0.05). Conclusion The pelvic floor function of the patients after total hysterectomy was not significantly damaged within 1 month
but began to be damaged after 3 months
and then progressed slowly.Transperineal three-dimensional ultrasonography can accurately assess the pelvic floor function of patients after total hysterectomy
and it is recommended that patients undergoing total hysterectomy should be begin pelvic floor rehabilitation training between 1 and 3 months after the operation.
子宫全切术盆底经会阴三维超声
Total hysterectomyPelvic floorTransperineal three-dimensional ultrasonography
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