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目的比较Ⅱ型和Ⅲ型膀胱脱垂在声像图特征及临床表现的差异。方法应用经会阴超声观察膀胱脱垂Ⅱ型和Ⅲ型患者的盆底信息,张力期观察尿道内口是否呈漏斗状开放,测量膀胱颈移动度、膀胱尿道后角及尿道旋转角。比较膀胱脱垂Ⅱ型和Ⅲ型患者临床表现、声像图特征及超声测量参数。结果膀胱脱垂Ⅱ型患者张力期膀胱尿道后角开放、颈部脱垂明显,膀胱颈移动度大于Ⅲ型患者,尿道内口漏斗状开放和压力性尿失禁发生率高。膀胱脱垂Ⅲ型患者张力期膀胱尿道后角完整、后基底部脱垂明显,患者排尿困难、排空功能障碍发生率高。结论Ⅱ型和Ⅲ型膀胱脱垂有着不同的临床表现及声像图特征,膀胱尿道后角是否开放以及脱垂最低点的不同是两者最显著的声像图差异,也是临床表现差异的重要原因。
Objective To compare the characteristics and clinical manifestations of type Ⅱ and type Ⅲ bladder prolapse. Methods Pelvic floor information of type Ⅱ and type Ⅲ patients with bladder prolapse was observed by perineal ultrasonography. The mouth of the urethra was opened in a funnel shape during tension period. The degree of movement of the bladder neck, the angle of urinary bladder and urethral rotation were measured. The clinical manifestations, sonographic features and ultrasonic parameters of patients with type Ⅱ and type Ⅲ bladder cancer were compared. Results Bladder prolapse type Ⅱ patients had open posterior horn of bladder and urethra, obvious neck prolapse and more bladder neck mobility than type Ⅲ patients. The incidence of open funnel and pressure incontinence in the urethra was high. Bladder prolapse type Ⅲ patients with complete posterior chamber angle of bladder and urethra, prolapse of the base after the obvious dysuria patients, the high incidence of emptying dysfunction. Conclusions The clinical manifestations and sonographic features of type Ⅱ and type Ⅲ bladder prolapse, whether the posterior urethral angle is open or not, and the lowest point of prolapse are the most significant differences between the two cases and are also important for the differences in clinical manifestations the reason.