The Clinical Research Of Pelvic Diaphragm Hiatus Morphology By Transperineal Three-dimensional Ultrasound In Patients After Hysterectomy

Objective To observe the pelvic diaphragm hiatus morphology by transperineal three-dimensional ultrasound in patients after hysterectomy.To investigate the clinical application value of transperineal three-dimensional ultrasound to evaluate pelvic function of patients after total hysterectomy.To explore the effect of hysterectomy on pelvic floor function by comparing the static and dynamic changes of pelvic structure in patients after hysterectomy with normal multipara.Methods From January 2015 to December 2016 in Affiliated Hospital of Jining Medical College after the uterus cutting technique for female patients with 50 cases as the research object,in the same period were performed in 50 cases without hysterectomy in healthy women as control group.Using the United States GE VOLUSON E8 color Doppler diagnostic instrument,the configuration of the RIC5-9-D three-dimensional volume cavity probe and abdominal 3D/4D convex array probe(RAB6-D),the frequency of 5-9Mhz,the maximum scan angle of 120 degrees.Pelvic ultrasound condition case group and control group in the instrument set complete,with the lower edge of pubic symphysis were measured as the reference point,the parameters in patients before and after resting,Valsalva action and state of levator hiatus and transverse diameter,area and thickness of the puborectalis number.Results 1.The pelvic diaphragmatic hiatus could be clearly showed by transperineal three-dimensional ultrasound in all patients and the anteroposterior diameter,transverse diameter and area could be measured.2.The study group compared with the control group: in addition to the anal contraction state of the transverse size had no statistical significance(p>0.05),before and after the pelvic diaphragm in the resting state,Valsalva state and the state of the levator hiatal diameter,size and puborectalis muscle thickness were statistically significant difference(p<0.05),and and the study group size,size and puborectalis muscle thickness were higher than the control group,especially under the condition of Valsalva of pelvic diaphragm hiatus area significantly larger.3.Hysterectomy group in the Valsalva action,the bladder neck position is low,bladder neck and bladder the lowest point in even after the foot side following the reference line edge level of pubic symphysis under the hiatus area increases,combined with clinical and pelvic ultrasound diagnosis results after hysterectomy pelvic floor dysfunction(28)cases.Conclusions 1.The anatomical structure,position and movement of the pelvic diaphragm hiatus could be observed dynamically by transperineal three-dimensional ultrasound.2.The transperineal three-dimensional ultrasound could evaluate the size and form of pelvic diaphragm hiatus effectively at three different states in the study group and control group,and it had better diagnostic value for the morphology change of pelvic diaphragm hiatus.3.The occurrence of female pelvic floor dysfunction could be indicated indirectly by changes of the pelvic diaphragm hiatus parameters in three different states of the study group and control group.4.By comparing pelvic diaphragm hiatus parameters of the study group and the control,suggesting the effect of hysterectomy on pelvic floor support structure,so as to provide theoretical support for clinical improvement of surgery,and reducing occurrence of female pelvic floor dysfunction disease.