Comparative Study On The Advantages Of Pelvic Floor Ultrasound And Defecography In The Diagnosis Of Qi-Deficiency Constipation

Objective: To compare the application value of pelvic floor ultrasound and defecography in the diagnosis of qi-deficiency constipation,and to discuss the advantages and disadvantages of pelvic floor ultrasound and defecography in the diagnosis of qi-deficiency constipation.Methods: A total of 40 patients with Qi-deficiency constipation were selected,and defecography and pelvic floor ultrasound were performed at the same time.The corresponding imaging data and examination results were generated after the examination.The statistical data was analyzed using SPSS25.0 software,and defecography was used as the reference standard to evaluate the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of pelvic floor ultrasound for the diagnosis of Qi-deficiency constipation.Compare the difference between pelvic floor ultrasound and defecography in measuring the anorectal angle,the depth of rectal protrusion,and the supraanal distance,and analyze the advantages and disadvantages of the two in the diagnosis of Qi-deficiency constipation.Results: 1.There are 33 cases of rectocele detected by pelvic floor ultrasound,including 31 true positives,2 false positives,6 true negatives,and 1 false negative.The sensitivity is 97%(31/32)and the specificity is75 %(6/8),the positive predictive value is 94%,and the negative predictive value is 86%;19 cases of perineal decline were detected,including 18 true positives,1 false positive,10 true negatives,and 11 false negatives.The sensitivity was 62%(18/29),the specificity was 91%(10/11),the positive predictive value was 95%,and the negative predictive value was 48%.2.Pelvic floor ultrasound and defecography have a high degree of consistency in the diagnosis of rectocele and moderate consistency in the diagnosis of perineal decline(P<0.05);they have a high degree of consistency in the diagnosis and classification of rectocele(P<0.05).3.There is no statistically significant difference between pelvic floor ultrasound and defecography in the detection rate of rectocele(P>0.05),and the detection effect of the two is equivalent;The detection rate of perineal descent by pelvic floor ultrasound is lower than that by defecography(P<0.05).4.The overall measurement of the supraanal distance and the depth of rectocele by pelvic floor ultrasound is smaller than that by defecography(P<0.05).However,there is no significant difference between the two in the average value of the anal right angle(P>0.05).5.Pelvic floor ultrasound found diseases but not detected by defecography:3 cases of bladder prolapse(7.5%,3/40)and 2 cases of uterine prolapse(5%,2/40).Conclusion: Pelvic floor ultrasound and defecography have good consistency in the diagnosis of Qi-deficiency constipation,which is manifested as rectocele and perineal decline,and can be used as an alternative examination method for defecation.For people who can tolerate defecography and have no contraindications for defecography,defecography can be selected;pelvic floor ultrasound is better for some patients,such as claustrophobic syndrome,women of childbearing age and children,and patients with defecography taboo.Meanwhile,those two methods can be comprehensively analyzed to meet the diagnostic requirements if it is necessary to comprehensively evaluate the degree of pelvic floor lesions and observe the dynamic changes of pelvic floor muscles,it can provide reference for the follow-up surgical treatment.