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[放射骨盆测量法的现状]

[Status of radiologic pelvimetry].

作者信息

Alder C, Aebi S, Bernhard M

出版信息

Geburtshilfe Frauenheilkd. 1987 Jul;47(7):483-6. doi: 10.1055/s-2008-1035857.

Abstract

The diagnostic value of radiological pelvimetry is subject to controversial interpretation. This examination is being conducted at the Department of Gynaecology in Aarau (Frauenklinik Aarau) mainly in pregnant women in pelvic presentation or during the puerperium after Caesarean section. Based on 164 radiological pelvimetric measurements in breech presentation and 112 X-ray films after Caesarean section an attempt was made to assess the prospective value of this examination. Abnormal shapes of the pelvis and narrow pelvic dimensions were found about equally often. Analysis of the indications of the section yielded both in breech presentation and in the entire group of the patients examined post partum an almost equally high percentage of about 20% of indications for a disproportionate head-pelvis relationship. Radiologically, considerably narrowed pelvic dimensions were seen in 10% of the examined women. The most frequent finding was a funnel-shaped pelvis, whereas an assimilation pelvis was never seen. Every pathologically narrowed funnel-shaped pelvis and generally narrow pelvis was detected also by digital palpation. All cases of conjugata vera masses below 10 cm concerned generally narrow cases of pelvic dimensions and were thus detectable by digital palpation. We recommended to abstain from routine performance of radiometric pelvimetry. Lateral pelvic X-ray can be an additional help in difficulties in pregnant women with regard to determining the mode of birth in breech presentation and after Caesarean section in case there is an urgent suspicion of malproportionate head-pelvis ratios.

摘要

放射骨盆测量法的诊断价值存在争议性解读。这项检查主要在阿劳妇科(阿劳妇产科)对胎位为臀位的孕妇或剖宫产术后产褥期的妇女进行。基于164例臀位的放射骨盆测量和112例剖宫产术后的X光片,试图评估这项检查的前瞻性价值。骨盆形状异常和骨盆尺寸狭窄的发现频率大致相同。对剖宫产指征的分析显示,在臀位组和产后检查的整个患者组中,头盆不称指征的比例几乎相同,约为20%。在10%的受检女性中,放射学检查发现骨盆尺寸明显变窄。最常见的发现是漏斗形骨盆,而同化骨盆从未见过。通过指诊也能检测到每一例真结合径小于10厘米的病理性狭窄漏斗形骨盆和一般狭窄骨盆。所有真结合径小于10厘米的病例通常都是骨盆尺寸狭窄的情况,因此可通过指诊检测到。我们建议避免常规进行放射骨盆测量。对于胎位为臀位的孕妇以及剖宫产术后怀疑头盆比例严重失调的情况,骨盆侧位X光检查在确定分娩方式时可能会有所帮助。

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