Levator avulsion and grading of pelvic floor muscle strength
Levator avulsion and grading of pelvic floor muscle strength
复制标题
DOI：
10.1007/s00192-007-0491-9
复制
发表时间：
2008-05-01
影响因子：
1.8
通讯作者：
Shek, C.
中科院分区：
文献类型：
--
作者：
Dietz, H. P.;Shek, C.
在一项调查提肛肌撕脱与提肛肌力量临床分级之间关系的回顾性研究中，我们分析了在三级泌尿妇科诊所就诊的 1,112 名女性的 3D/4D 经阴唇超声和数字评估数据。当检查者无法触诊耻骨下支上的耻骨内脏肌的插入和/或超声检测到骨骼和肌肉之间的不连续性时，即可诊断提上睑肌撕脱。对于提上睑肌力量的临床分级，我们使用改良的牛津分级。 252 名女性 (23%) 发现撕脱缺陷，这与整体牛津分级的显着降低相关（2.07 vs 2.81，P < 0.001）。撕脱发生率的增加取决于改良牛津分级中的侧差：从无差异时的 16% 到侧差为 1.5 或更高时的 76%（P < 0.001）。耻骨直肠肌撕脱似乎对盆底肌肉力量有显着影响，这可能有助于诊断创伤。
In a retrospective study investigating the relationship between levator avulsion and clinical grading of levator ani muscle strength, we analyzed the 3D/4D translabial ultrasound and digital assessment data of 1,112 women seen in a tertiary Urogynecological clinic. Levator avulsion was diagnosed whenever the examiner was unable to palpate the insertion of the pubovisceral muscle on the inferior pubic ramus and/or whenever a discontinuity between bone and muscle was detected on ultrasound. For clinical grading of levator muscle strength, we used the modified Oxford grading. Avulsion defects were found in 252 women (23%), and this was associated with a highly significant reduction in the overall Oxford grading (2.07 vs 2.81, P < 0.001). The prevalence of avulsion increased depending on the side differences in the modified Oxford grading: from 16% when there was no difference to 76% when the side difference was 1.5 or higher (P < 0.001). Avulsion of the puborectalis muscle seems to have a marked effect on pelvic floor muscle strength, which may help in diagnosing trauma.