目的 探讨女性慢性盆腔疼痛综合征(chronic pelvic pain syndrome,CPPS)患者盆底超声影像学改变特征,为CPPS的诊治提供依据.方法 选取2015年1月至2016年12月在大连市妇女儿童医疗中心就诊的66例CPPS患者和81例非CPPS健康人群,比较静态和Valsalva状态下膀胱颈与耻骨联合前下缘水平线之间的距离(BND)、膀胱底与耻骨联合前下缘水平线之间的距离(BSD)、尿道长度、生殖道裂孔前后径、肛直肠角度等参数的变化.比较两组在肛提肌裂孔前后径、横径及面积,阴道旁间隙面积,肛提肌面积,肛提肌厚度等参数的变化特征.结果 研究组静息状态下生殖道裂孔前后径[(53.23±7.70)mm vs.(57.53±9.59)mm]小、于对照组(P＜0.05),肛直肠角度[(115.69±13.28)°vs.(109.31±l3.26)°]大于对照组(p＜0.05);Valsalva状态下BSD[(6.70± 14.91)mm vs.(0.13±15.10)mm]大于对照组(P＜0.05).研究组肛提肌裂孔前后径[(51.25±6.14)mm vs.(58.80±7.36)mm]、肛提肌裂孔横径[(39.44± 6.07)mm vs.(47.92±8.18)mm]、肛提肌裂孔面积[(13.74±2.51)mm2 vs.(18.31±3.47) mm2]、阴道旁间隙左右侧面积[(2.07±0.71) mm2 vs.(2.94± 1.19) mm2,(2.02±0.52) mm2 vs.(2.87±0.87)mm2]均明显小于对照组(P＜0.0001).肛提肌中间厚度[(5.59± 1.99)mm vs.(4.60± 1.92)mmn]大于对照组(P＜O.05).结论 女性CPPS盆底超声影像学显示为肛提肌痉挛性特征.%Objective To discuss the characteristic changes in women with chronic pelvic pain syndrome (CPPS)by pelvic ultrasonography,and to provide evidences for the diagnosis and treatment of CPPS.Methods Totally 66 patients with CPPS were collected as the experiment group and 81 healthy people without CPPS were chosen as the control group in Dalian Municipal Women and Children's Medical Center from Jan.2015 to Dec.2016.The values of the distance between the bladder neck and the anterior inferior margin of the symphysis pubis (BND),the distance between the bottom of the bladder and the horizontal line of the anterior inferior edge of the pubic symphysis (BSD),the length of the urethra,the anteroposterior diameter of the genital tract and the anorectal angle were compared between CPPS and control group under stationary and Valsalva state.The parameters of two groups were compared,such as the anteroposterior diameter,transverse diameter and area of the levator hiatus,the area of the lateral vaginal space,the area of the levatorani muscle,and the thickness of the levatorani muscle to find the characteristic changes.Results The static anteroposterior diameter of the genital tract in CPPS group was smaller than in control group [(53.23±7.70)mm vs.(57.53±9.59) mm,P＜0.05].The static anorectal angle in CPPS group was larger than in control group [(115.69± 13.28)°vs.(109.31± 13.26)°,P＜0.05].BSD was larger in CPPS group than in control group[(6.70± 14.91mm vs.(0.13±15.10)mm,P＜0.05] under the condition of Valsalva.The anteroposterior diameter of the levator hiatus [(51.25±6.14) mm vs.(58.80±7.36) mm],the transverse diameter of the levator hiatus[(39.44±6.07)mm vs.(47.92±8.18)mm],the area of levator hiatus[(13.74±2.51)mm2 vs.(18.31±3.47)mm2],the area of the left and right sides of the vaginal space [(2.07±0.71) mm2 vs.(2.94± 1.19) mm2,(2.02±0.52) mm2 vs.(2.87±0.87mm2)] were significantly lower in CPPS group than in control group (P＜0.0001),while the thickness of the intermediate of levatorani muscle was lager in CPPS group than in control group [(5.59± 1.99)mm vs.(4.60± 1.92) mm,P＜0.05].Conelusion The study shows that there are the characteristics of the levatorani muscle spasm in women with chronic pelvic pain syndrome detected by pelvic ultrasonography.
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