曹宁宁

[摘要] 目的 探討联合应用阴道探头及表浅探头诊断盆底及外阴疾病临床。方法 方便选择2014年5月—2016年2月期间该院收治的70例盆底及外阴疾病患者作为研究对象，随机分为对照组和观察组，各35例。两组受试者均在该院行外科治疗，术前对照组患者采用阴道探头行阴道三维超声扫描观察患者盆底形态学及外阴创伤情况，观察组在对照组基础上增加表浅探头联合扫描检查。比较两组患者三维超声结果与外科手术结果符合率，并观察盆底功能障碍性疾病的影像学表现。结果 观察组超声诊断结果与外科手术结果符合率为91.43%，显著高于对照组（71.43%），且观察组盆腔器官脱垂、压力性尿失禁超声诊断符合率显著高于对照组，组间差异有统计学意义（P<0.05）。盆腔器官脱垂超声影像学表现：静息状态阴道两侧不对称且未完全闭合，两侧肛提肌对称性欠佳或不对称，回声不均匀，缩肛动作状态腔内缩小、肛提肌裂孔缩小，Vasaval 动作状态阴道腔增大，肛提肌裂孔形态不规则且明显增大，可见脱垂回到阴道子宫回声。压力性尿失禁超声影像学表现：静息状态阴道腔未完全闭合，两侧不对称明显，阴道“蝴蝶”形态消失，肛提肌肌肉周围结缔组织疏松、缩肛状态肛提肌出现轻度增厚或不增厚，肛提肌裂孔缩小，Vasaval状态阴道腔持续增大、肛提肌侧支不对称、肛提肌无变化或厚度轻度降低。结论 联合应用阴道探头及表浅探头诊断盆底及外阴疾病准确性较高，有助于提高盆底功能障碍性疾病及外阴疾病超声诊断效果，为临床治疗提供可靠依据。

[关键词] 阴道探头；表浅探头；盆底疾病； 压力性尿失禁；外阴疾病

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0001-04

[Abstract] Objective To study the clinical effect of combined application of transvaginal probe and superficial probe in diagnosis of pelvic floor or vulva diseases. Methods Convenient selection 70 cases of patients with pelvic floor or vulva diseases admitted and treated in our hospital from May 2014 to February 2016 were selected and randomly divided into two groups with 35 cases in each， both groups adopted the surgical treatment， the control group adopted the transvaginal probe for three dimensional ultrasound scanning to observe the pelvic floor morphology and vulva wound， while the observation group added the superficial probe scan on the basis of the control group， and the three dimensional ultrasound results and coincidence rate of surgical surgery results were compared between the two groups， and the imaging manifestations of pelvic floor dysfunctional diseases were observed. Results The coincidence rate of ultrasound diagnosis results and surgical surgery results was obviously higher than that in the control group （91.43% vs 71.43%）， and the coincidence rate of pelvic organ prolapse and stress urinary incontinence in the observation group were obviously higher than those in the control group， and the differences between groups were statistically significant（P<0.05）， and the ultrasound imaging manifestations of asymmetrical bilateral vagina resting state， bad or asymmetrical bilateral levator ani muscle and the echo was uneven， levator ani muscle hiatus was shortened， vaginal canal of vasaval action state increased， levator ani muscle shape was irregular and obviously increased； the imaging manifestations of stress urinary incontinence： vaginal canal in the resting state was not totally closed， and the asymmetrical bilateral vagina was obvious， vaginal "butterfly" shape disappeared， levator ani muscle hiatus was shortened， vaginal canal of vasaval state continuously increased， levator ani muscle was asymmetrical and had no changes or the thickness slightly decreased. Conclusion The accuracy of combined application of transvaginal probe and Superficial probe in diagnosis of pelvic floor or vulva diseases contributes to improving the diagnosis results of transvaginal probe and superficial probe in diagnosis of pelvic floor or vulva diseases， which can provide reliable for the clinical treatment.

[Key words] Transvaginal probe； Superficial probe； Pelvic floor diseases； Stress urinary incontinence； Vulva diseases

盆底疾病是由于激素水平、自然衰老、分娩、妊娠等复杂因素引发的妇科疾病，以盆底功能障碍形疾病为主[1]。外阴疾病也是女性常见疾病，其与盆底疾病同属于妇科高发疾病，在两者临床治疗中，超声检查仍是重要的辅助手段。随着超声探测技术的发展，超声探头

从传统腹部表浅探头发展形成了新型阴道探头，使得女性腹部疾病无创检查诊断准确率显著提升[2]。当前，阴道探头在妇科疾病治疗中应用较多，但联合应用阴道探头及表浅探头诊断盆底及外阴疾病的临床文献报道较少，故该研究方便选择2014年5月—2016年2月期间该院收治的70例盆底及外阴疾病患者作为研究对象，对该联合检查手段诊断价值进行了分析，现报道如下。……