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盆底超声检查对盆腔器官脱垂诊断的价值:一项系统评价

Diagnostic value of pelvic floor ultrasonography for diagnosis of pelvic organ prolapse: a systematic review.

作者信息

Gao Yuanjing, Zhao Zhiwei, Yang Yanlin, Zhang Meiqin, Wu Jiang, Miao Yali

机构信息

Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, West China Second University Hospital, West China Campus, Sichuan University, No.17 People's South Road, Chengdu, 610041, China.

West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China.

出版信息

Int Urogynecol J. 2020 Jan;31(1):15-33. doi: 10.1007/s00192-019-04066-w. Epub 2019 Aug 28.

Abstract

INTRODUCTION AND HYPOTHESIS

Pelvic organ prolapse (POP) is a common medical condition universally. In addition to physical examination, experts have increasingly turned their attention to ultrasound in diagnosing POP for its low cost and dynamic imaging. The aim of this paper is to provide an overview of the methods of pelvic floor ultrasound in diagnosing POP, which has been lacking up till now.

METHODS

We included original papers comparing the outcome of the Pelvic Organ Prolapse Quantification system and ultrasound, published from 2008 to present in English, using electronic databases (MEDLINE, EMBASE, CENTRAL, PUBMED). All stages of the review were conducted in parallel by two reviewers.

RESULTS

Fifteen papers were included. We found that current methods have advantages and limitations. The main methods are to measure levator hiatus-related parameters and distances between the lowest point of the pelvic organs and reference lines during Valsalva maneuver, contraction, and at rest.

CONCLUSIONS

Pelvic floor ultrasound is valuable in diagnosing POP, yet suffers from a weakness in precision compared with physical examination. From the existing research, we found that the differences in baseline data such as weight, height, ethnicity, etc., may affect the cutoffs of the above-mentioned parameters. Further research is required to find one appropriate cutoff for each parameter, even if it is necessary to set group values for every parameter according to varying situations.

摘要

引言与假设

盆腔器官脱垂(POP)是一种普遍存在的常见病症。除体格检查外,由于超声检查成本低且具有动态成像功能,专家们越来越多地将注意力转向超声在POP诊断中的应用。本文旨在对盆底超声诊断POP的方法进行综述,而目前这方面的综述尚付阙如。

方法

我们纳入了2008年至今以英文发表的、比较盆腔器官脱垂定量系统和超声检查结果的原始论文,通过电子数据库(MEDLINE、EMBASE、CENTRAL、PUBMED)进行检索。综述的所有阶段均由两名评审员并行进行。

结果

共纳入15篇论文。我们发现当前的方法有其优点和局限性。主要方法是在用力排便动作、收缩及静息状态下测量提肛裂孔相关参数以及盆腔器官最低点与参照线之间的距离。

结论

盆底超声在POP诊断中具有重要价值,但与体格检查相比,其精确性存在不足。从现有研究来看,体重、身高、种族等基线数据的差异可能会影响上述参数的临界值。需要进一步研究为每个参数找到合适的临界值,甚至可能有必要根据不同情况为每个参数设定分组值。

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