54 ( )2017 57 5 JournalofNanchangUniversity(MedicalSciences)2017Vol.57No.5 ( 330006) : (POP) POP POP 63 (POP ) POP 40 ( ) 2 POP 10 12 23 3 2 13 (P<0.05) (P>0.05); (POP-Q) Ⅰ Ⅱ Spearman 0.46 0.83 POP : ; ; : R711.2 ;R445.1 : A : 2095-4727 (2017)05-0054-04 DOI:10.13764/j.cnki.ncdm.2017.05.013 ApplicationofTransperinealUltrasonographyin DiagnosisofPelvicOrganProlapse ZHANGJieCHENLi (Departmentof Ultrasoundthe FirstAffiliated Hospitalof Nanchang UniversityNanchang330006China) ABSTRACT:Objective Toexplorethevalueoftransperinealultrasonographyindiagnosisofpel- vicorganprolapse(pop)andtoprovideareferenceforultrasonic-assisteddiagnosisandquantita- tiveevaluationofpop.methods Sixty-threepatients with POP(POPgroup)and40patients withoutobviouspop(controlgroup)wereselectedfrom outpatientandinpatientdepartments. Transperinealultrasonographywasperformedtoobservepelvicfloorstructure.Moreoverthepo- sitionandmovementofbladderneckcervixandrectalampulawererecordedduringrestingval- salvaandcontraction.results Therewere10casesofurethraldescending12casesofbladder bulging23casesofuterineprolapse3casesofperinealbodydescending2casesofrectalbulging and13casesofmultipleorganprolapseinpopgroup.thepositionsofbladderneckcervixand rectalampulainpopgroupwerelowerthanthoseincontrolgroup(p<0.05).therewereno significantdiferencesinmovementrangebetweenthetwogroups(p>0.05).thespearmancor- relationcoeficientsbetweenpelvicorganprolapsequantification(pop-q)stageiand Iprolapse andtransperinealultrasonographicevaluationwere0.46and0.83respectively.conclusion The observationofpelvicfloorstructurebytransperinealultrasonographyisofgreatvalueinthediag- nosisandtreatmentofpop. KEY WORDS:transperinealultrasonography;pelvicorganprolapse; pelvicorganprolapsequantification :2017-03-24 : (1986 ) : E-mail:1727237899@qq.com
: 55 (POP) (RA-VD) 1 1.4 POP POP 60% 60 [1] 25% ( ) POP POP ; POP-Q POP ; 1 1.1 2014 5 2016 10 1.5 103 SPSS19.0 t ; Spearman POP P<0.05 103 POP (POP )63 2 35~77(56.21±8.35) BMI(23.29±1.21)kg m -2 (2.38±1.42); 22 2.1 2 23 5 POP ( 22 23 13 POP 40 ( ) 39~74(56.53±8.55) BMI (22.94±1.08)kg m -2 (2.40±1.45) 2 (10 12 ); BMI (P>0.05) 23 ; 5 (3 2 1.2 ); :13 (2 GE ;2 ;1 VolusonE8 RIC5-9-D ;8 ) 5~9 MHz 180 5 13 ) : 22 POP 2.2 2 1.3 POP BN-VD C-VD RA-VD (P < 0.05) 45 POP (P>0.05) (P<0.05) (Valsalva ) : (P<0.05) (BN-VD) (P<0.05) 1 3 (C-VD)
56 ( )2017 10 57 5 1 2 (BN-VD) x±scm n (r) (v) (c) P (r-v) P(r-c) BN-VD r-v BN-VD r-c 40 3.37±0.71 2.20±0.23 3.89±0.42 <0.05 <0.05 1.17±0.55-0.52±0.40 POP 63 1.82±0.90 0.65±1.48 2.34±0.83 <0.05 <0.05 1.27±0.84-0.42±0.18 P <0.05 <0.05 <0.05 >0.05 >0.05 r-v: ; r-c: 2 2 (C-VD) x±scm n (r) (v) (c) P (r-v) P(r-c) C-VD r-v C-VD r-c 40 4.38±0.48 3.52±0.26 5.37±0.46 <0.05 <0.05 0.86±0.29-0.99±0.13 POP 63 2.09±1.31 0.56±1.82 2.67±1.17 <0.05 <0.05 1.54±0.92-0.58±0.27 P <0.05 <0.05 <0.05 <0.05 <0.05 3 2 (RA-VD) x±scm n (r) (v) (c) P (r-v) P(r-c) RA-VD r-v RA-VD r-c 40 3.0±0.31 2.27±0.38 3.77±0.23 <0.05 <0.05 0.73±0.12 0.77±0.13 POP 63 2.12±0.61 1.47±0.92 2.44±0.64 <0.05 <0.05 0.64±0.42 0.33±0.22 P <0.05 <0.05 <0.05 >0.05 <0.05 2.3 Ⅰ Ⅱ 1990 Petros IntegralTheory 63 POP : 22 Delancey 23 5 13 ( 11 13 4 ); POP-Q :33 Ⅰ 36 Ⅱ 9 [2] POP Ⅰ Ⅱ 3.2 POP Spearman 0.46 0.83 4 4 Ⅰ (n=33) Ⅱ (n=36) POP-Q 1.42±0.49-0.28±0.53 0.59±0.30-1.25±0.47 : 3 MRI X CT FPFD POP MRI Ⅰ Ⅱ x±scm MRI [3-5] MRI POP 3.1 POP [6] ( ) ( ) ) POP
: 57 : 1981 85% 98% [11] 2 Val- salva ; (ICS)1996 POP-Q 3 3.4 POP 3.3 POP 63 POP POP-Q : 22 23 5 13 Valsalva Yalcin [12] : 22 (10 12 ); 23 X 45 ; 5 (3 2 ); :13 (2 ;2 ;1 ;8 ) Dietz POP-Q [7-8] SUI Kluivers [13] POP-Q I 14mm POP 30% 4 : Ⅰ (0.59± [1] 0.30)cm Ⅱ (-1.25±0.47)cm POP-Q Ⅰ (1.42±0.49)cm Ⅱ POP (-0.28±0.53)cm 1cm BN-VD C-VD RA-VD (P< 0.46 0.83 0.05)POP Ⅱ Dietz [714] [15] POP : Ⅰ : ;Ⅱ : 2cm [7-9] SUI POP-Q SUI POP Santoro [10] >1.5cm ( 65 )
: 65 Endocrinol2017176(1):1-9. [6] Klein HesselinkE NKlein Hesselink M SdeBockG Hetal. Long-termcardiovascularmortalityinpatientswithdiferentia- tedthyroidcarcinoma:anobservationalstudy[j].jclinoncol 201331(32):4046-4053. [7] RazviSIngoeLKeekaGetal.ThebeneficialefectofL-thy- roxineoncardiovascularriskfactorsendothelialfunctionand qualityoflifeinsubclinicalhypothyroidism:randomizedcross- overtrial[j].jclin Endocrinol Metab200792(5):1715-1723. [8] JabbarAPingitore APearceS Hetal.Thyroidhormones andcardiovasculardisease[j].natrevcardiol201714(1): 39-55. [9] LevickSFenningABrownL.Increasedcalciuminfluxmedi- atesincreasedcardiacstifnessinhyperthyroidrats[j].cel Biochem Biophys200543(1):53-60. [10] KahalyGJDilmann W H.Thyroidhormoneactioninthe heart[j].endocrrev200526(5):704-728. phy[j].jclinendocrinolmetab200590(2):673-677. [12]. [11] D rrmwolfbrobinsond Metal.Theassociationofthy- roidfunctionwithcardiacmassandleftventricularhypertro- Meta [J]. ( )201252(3):28-3041. [13] GazdagANagyE VErdeiAetal.Aorticstifnessandleft ventricularfunctionin patients with diferentiatedthyroid cancer[j].jendocrinolinvest201538(2):133-142. [14] Klein HesselinkE NLefrandtJDSchuurmansEPetal.In- creasedriskofatrialibrilationaftertreatmentfordiferentia- tedthyroidcarcinoma[j].jclinendocrinolmetab2015100 (12):4563-4569. [15] AbdulrahmanR MDelgadoVHoftijzerH Cetal.Bothex- ogenoussubclinicalhyperthyroidismandshort-termoverthy- pothyroidismafectmyocardialstraininpatientswithdifer- entiatedthyroidcarcinoma[j].thyroid201121(5):471-476. [16] Tadic MCelicVCuspidiCetal.Howdoessubclinicalhyper- thyroidismafectrightheartfunctionand mechanics [J].J Ultrasound Med201635(2):287-295. [17] BiondiBCooperDS.Benefitsofthyrotropinsuppressionversus therisksofadverseefectsindiferentiatedthyroidcancer[j]. Thyroid201020(2):135-146. ( : ) 櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐 ( 57 ) : [1]. [M]. : 2008: graphicmeasurementofbladderneck mobilityinthemanage- mentoffemalestressurinaryincontinence[j].gynecolobstet 58-59. Fertil201139(1):42-48. [2] PetrosPE. - [10] SantoroGWieczorekADietzH Petal.Stateoftheart:an [M].. : 2007:107-109. [3] integratedapproachtopelvicfloorultrasonography[j].ultra-. MRI soundobstetgynecol201137:381-396. [J]. [11]. 201314(1):47-49. [J]. [4] PizzoferratoA CTimoh K NFritelXetal.Dynamic Magnetic 201512(12):50-53. ResonanceImagingandpelvicfloordisorders:howandwhen [J]. [12] Yalcin O THassa HOzalpS.Efectivenessofultrasono- EurJObstetGynecolReprodBiol2014181(181):259-266. [5] graphicparametersfordocumentingtheseverityofanatomic Brand o SParente MMascarenhas Tetal.Biomechanical stressincontinence[j].actaobstetgynecolscand200079 studyonthebladderneckandurethralpositions:simulationof (5):421-426. impairmentofthepelvicligaments[j].jbiomech201548(2): [13] KluiversKBHendriksJC MShekCetal.Pelvicorganpro- 217-223. [6] lapsesymptomsinrelationtopopqordinalstagesandultra- NotenKJKluiversKBFütererJJetal.Translabialthree- soundprolapseassessment[j].inturogynecolj200819(9): dimensionalultrasonographycomparedwithmagneticresonance 1299-1302. imagingindetectinglevatoranidefects[j].obstet Gynecol [14]. [J]. 2014124(6):1190-1197. 201228(12):2229-2232. [7] DietzH PHaylenBTBroomeJ.Ultrasoundinthequantifica- [15]. POP-Q tionoffemalepelvicorganprolapse[j].ultrasoundobstetgy- [J]. 201322(8):45-48. necol200118(5):511-514. [8] ChantarasornVDietzH P.DiagnosisofCystoceletypebyclin- icalexaminationandpelvicfloorultrasound[j].ultrasoundob- stetgynecol201239(6):710-714. [9] Pizzoferrato AFauconnier ABader G.Valueofultrasono- ( : )
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