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Role and significance of pelvic four-constrast defecography in the diagnosis of outlet obstructive constipation
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
- Issue:
- 2
- DOI:
- 10.3760/cma.j.issn.1671-0274.2007.02.003
- Key Word:
- 四重造影,盆腔;便秘,出口梗阻性;诊断
Abstract： 目的 研究出口梗阻性便秘(OOC)患者盆底形态变化和盆腔脏器间的相互关系.方法 对59例经物理检查初步诊断为OOC的患者和12例正常自愿者行排粪造影,结合盆底、膀胱造影,女性阴道放置浸钡标记物(四重造影)检查,测量肛直角、会阴位置、盆底腹膜位置、膀胱位置.结果 在59例OCC患者中,经盆腔四重造影诊断直肠内脱垂46例,盆底腹膜疝29例,直肠前突7例,盆底肌痉挛综合征7例,会阴下降综合征5例;还发现膀胱脱垂6例,子宫后倾或脱垂10例.与正常自愿者相比,OOC组力排相肛直角明显增大(P＜0.05),静息相和力排相会阴异常下降(P＜0.05,P＜0.01),力排相盆底腹膜位置下降非常显著(P＜0.01).OOC组中伴泌尿系症状者静息相和力排相膀胱位置均显著低于正常自愿者(P＜0.05,P＜0.01).结论 盆腔四重造影可有效诊断直肠内脱垂和直肠前突:对临床症状隐匿、物理检查难以诊断的盆底腹膜疝以及膀胱、子宫脱垂提供了诊断依据;有助于选择正确合理的治疗方法.
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