CAJ | 학술논문

目的探讨动态三维超声对盆底松弛综合征患者治疗前后肛提肌裂隙形态结构改变方面的评估价值.方法 2011年10月到2012年9月间于南京市中医院便秘专病门诊筛选出盆底松弛综合征所致便秘的40例女性患者,填写克里夫兰便秘评分(CCS评分)量表,并在Valsalva动作时进行动态三维超声检查,测量患者肛提肌裂隙的前后径和左右径.经1个疗程(2周)的生物反馈和针灸治疗后,再次填写治疗后CCS评分量表并复查Valsalva动作时的动态三维超声.结果最终有25例盆底松弛综合征女性患者接受治疗前、后的动态三维超声检查并完成CCS评分量表.与治疗前相比,治疗后Valsalva动作时动态三维超声所测得的肛提肌裂隙纵轴[(5.13±0.82)cm比(4.89±0.89) cm,P＜0.01]、横轴[(4.86±0.74) cm比(4.62±0.75) cm,P＜0.01]和面积[(19.92±6.33) cm2比(18.16±6.42) cm2,P＜0.01]均明显减小,CCS评分亦明显下降[(15.80±3.42)比(9.52±2.50),P＜0.01).结论使用动态三维超声可以为女性盆底松弛综合征肛提肌裂隙的测定提供一种简单、无创并有效的影像学检测方法.
목적 탐토동태삼유초성대분저송이종합정환자치료전후항제기렬극형태결구개변방면적평고개치.방법 2011년10월도2012년9월간우남경시중의원편비전병문진사선출분저송이종합정소치편비적40례녀성환자,전사극리부란편비평분(CCS평분)량표,병재Valsalva동작시진행동태삼유초성검사,측량환자항제기렬극적전후경화좌우경.경1개료정(2주)적생물반궤화침구치료후,재차전사치료후CCS평분량표병복사Valsalva동작시적동태삼유초성.결과 최종유25례분저송이종합정녀성환자접수치료전、후적동태삼유초성검사병완성CCS평분량표.여치료전상비,치료후Valsalva동작시동태삼유초성소측득적항제기렬극종축[(5.13±0.82)cm비(4.89±0.89) cm,P＜0.01]、횡축[(4.86±0.74) cm비(4.62±0.75) cm,P＜0.01]화면적[(19.92±6.33) cm2비(18.16±6.42) cm2,P＜0.01]균명현감소,CCS평분역명현하강[(15.80±3.42)비(9.52±2.50),P＜0.01).결론 사용동태삼유초성가이위녀성분저송이종합정항제기렬극적측정제공일충간단、무창병유효적영상학검측방법.
Objective To explore the value of dynamic three-dimensional ultrasound in detecting the levator ani muscle fissures morphological changes of female pelvic floor relaxation syndrome after biofeedback and acupuncture treatments.Methods Forty female constipation patients with pelvic floor relaxation syndrome were screened from the Constipation Designed Disease Clinic in our hospital between October 2011 and September 2012.Cleveland Constipation Score (CCS) scale was used.Anteroposterior and transverse diameters of the levator ani muscle fissures were measured by dynamic three-dimensional ultrasound in Valsalva maneuver.After a course (10 days) of biofeedback and acupuncture treatments,CCS scale was filled,and dynamic three-dimensional ultrasound was performed in Valsalva maneuver as well.Associated data before and after treatment were compared.Results Twenty-five patients completed the trial.As compared to pre-treatment,the longitudinal axes of levator ani muscle fissure[(4.89±0.89) cm vs.(5.13±0.82) cm,P＜0.01],the horizontal axes of the levator ani muscle fissure [(4.62±0.75) cm vs.(4.86±0.74) cm,P＜0.01],and the area of the levator ani muscle fissure [(18.16±6.42) cm2 vs.(19.92±6.33) cm2,P＜0.01] decreased significantly after treatment,while CCS scale (9.52±2.50 vs.15.80±3.42,P＜0.01) declined significantly as well.Conclusions The dynamic three-dimensional ultrasound is an effective,simple and non-invasive method for the determination of levator ani muscle fissure in female patients with pelvic floor relaxation syndrome.