目的:分析不同程度子宫脱垂诊断中盆底超声检查患者肛直肠角变化的临床应用.方法:回顾性选取2020年1月-2022年12月本院盆底超声检查女性患者82例,统计分析盆底超声检查和手术病理检查的子宫脱垂程度、子宫脱垂合并症,并统计分析不同程度子宫脱垂患者的ARA,统计分析治疗前后子宫脱垂程度.结果:盆底超声检查和手术病理检查子宫脱垂程度的准确度93.90%(77/82)、100.00%(82/82)之间的差异不具有统计学意义(x2=3.301,P>0.05).盆底超声检查和手术病理检查的阴道前壁膨出、阴道后壁膨出、阴道前后壁膨出发生率41.46%(34/82)、41.46%(34/82)、10.98%(9/82)vs45.12%(37/82)、42.68%(35/82)、12.20%(10/82)之间的差异不具有统计学意义(x2=0.037,P<0.05).Ⅱ度+Ⅲ度+Ⅳ度子宫脱垂患者的vARA高于无脱垂、Ⅰ度脱垂患者,差异具有统计学意义(P<0.05),Valsalva状态下ARA变化大于无脱垂、Ⅰ度脱垂患者,差异具有统计学意义(P<0.05),无脱垂患者的vARA高于Ⅰ度脱垂患者,差异具有统计学意义(P<0.05),Valsalva状态下ARA变化大于Ⅰ度脱垂患者,差异具有统计学意义(P<0.05),但不同程度子宫脱垂患者的rARA、cARA、缩肛状态下ARA变化之间的差异不具有统计学意义(P>0.05).治疗前、治疗1个疗程、治疗3个疗程的无脱垂、Ⅰ度脱垂比例均逐渐升高,Ⅱ度、Ⅲ度、Ⅳ度脱垂比例均逐渐降低,差异具有统计学意义(P<0.05),提肛肌裂孔周长、提肛肌裂孔面积均逐渐缩小,差异具有统计学意义(P<0.05).结论:不同程度子宫脱垂诊断中盆底超声检查患者肛直肠角变化的临床应用价值高,子宫脱垂程度和vARA、Valsalva状态下ARA变化相关.
Objective:To analyze the clinical application of pelvic floor ultrasound in the diagnosis of anorectal angle changes in patients with different degrees of uterine prolapse.Methods:A retrospective analysis was conducted on 82 female patients who underwent pelvic floor ultrasound examination in our hospital from January 2020 to Decem-ber 2022.The degrees of uterine prolapse and complications of uterine prolapse were statistically analyzed through pelvic floor ultrasound examination and surgical pathology examination.The ARA of patients with different degrees of uterine prolapse were also statistically analyzed,and the degrees of uterine prolapse before and after treatment was statistically analyzed.Results:The difference in accuracy between pelvic floor ultrasound examination and sur-gical pathology examination for uterine prolapse between 93.90%(77/82)and 100.00%(82/82)is not statistically significant(x2=3.301,P>0.05).The incidence of vaginal anterior wall protrusion,posterior wall protrusion,and anterior and posterior wall protrusion in pelvic floor ultrasound examination and surgical pathology examination was 41.46%(34/82),41.46%(34/82),10.98%(9/82)vs 45.12%(37/82),42.68%(35/82),and 12.20%(10/82),and the difference between them was not statistically significant(x2=0.037,P<0.05).The vARA of patients with second degree,third degree,and fourth degree uterine prolapse was higher than that of patients with-out and with first degree prolapse,and the difference was statistically significant(P<0.05).The change in ARA in Valsalva state was greater than that in patients without and with first degree prolapse,and the difference was statistically significant(P<0.05).The change in ARA in Valsalva state was greater than that in patients with first degree prolapse,The difference was statistically significant(P<0.05),but the differences in rARA,cARA,and ARA changes under anal contraction in patients with different degrees of uterine prolapse were not statistically sig-nificant(P>0.05).The proportion of non prolapse and degree Ⅰ prolapse gradually increased before treatment,one course of treatment,and three courses of treatment,while the proportion of degree Ⅱ,Ⅲ,and Ⅳ prolapse gradu-ally decreased,with statistical significance(P<0.05).The circumference and area of the levator ani muscle hiatus gradually decreased,with statistical significance(P<0.05).Conclusion:The clinical application value of pelvic floor ultrasound in the diagnosis of anorectal angle changes in patients with varying degrees of uterine prolapse is high,the degree of uterine prolapse is related to vARA and the changes in ARA in Valsalva states.