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[从三维视角确定的狭窄骨盆——两步X线骨盆测量法]

[Contracted pelvis determined from a three-dimensional viewpoint--2 step X-ray pelvimetry].

作者信息

Iida S, Takahashi T

机构信息

Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo.

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1993 Jun;45(6):551-8.

PMID:8315314
Abstract

The definition of contracted pelvis set down by the Terminology Committee, Japan Society of Obstetrics and Gynecology concerns only the pelvic inlet. We maintain, however, that contracted pelvis in Japanese women should be considered from a three-dimensional viewpoint. It can be easily defined by the area of the pelvic inlet and the sacral shape. In the present study, the following results were obtained after extracting 108 sets of superior-interior and lateral pelviographs. 1) When the area of the pelvic inlet is > or = 110 cm 2, the possibility of contracted pelvis can be excluded. 2) When the area is < 100 cm2, the incidence of c/s is quite high; this condition should therefore be termed contracted pelvis. 3) Subjects with inlet areas of 100-110 cm2 are classified as "relative contracted pelvis" and account for about one third of the total number of patients. It is only in this group that lateral pelviographies should be taken. When it reveals the presence of sacral deformity, c/s is necessary in 1/2 of the cases, and vaginal deliveries can be expected in 95% without sacrum deformity. When a given pelvis is categorized as "normal" according to the definition, the c/s rate is as high as 50% in cases with a deformed sacrum, but when the sacrum is not deformed, the rate is as low as 25%, 4) The above technique consists of two steps: (a) First, a superior-inferior pelviography is taken to measure the inlet area to discriminate the high-risk group.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

日本妇产科学会术语委员会所规定的狭窄骨盆的定义仅涉及骨盆入口。然而,我们认为,对于日本女性的狭窄骨盆应从三维视角来考量。它可通过骨盆入口面积和骶骨形状轻易界定。在本研究中,提取108套骨盆入口上下位和侧位X线片后得出以下结果。1)当骨盆入口面积≥110平方厘米时,可排除狭窄骨盆的可能性。2)当面积<100平方厘米时,剖宫产发生率相当高;因此这种情况应被称为狭窄骨盆。3)入口面积为100 - 110平方厘米的受试者被归类为“相对狭窄骨盆”,约占患者总数的三分之一。仅对这组患者应拍摄骨盆侧位X线片。当显示存在骶骨畸形时,半数病例需要剖宫产,而无骶骨畸形时95%可期待经阴道分娩。当根据定义某一给定骨盆被归类为“正常”时,骶骨畸形病例的剖宫产率高达50%,但骶骨未变形时该率低至25%。4)上述技术包括两个步骤:(a)首先,拍摄骨盆上下位X线片以测量入口面积来鉴别高危组。(摘要截短于250字)

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