三维可视化探究广泛性全子宫切除术后阴道轴向长期变化差异

doi:10.13418/j.issn.1001-165x.2023.2.04

中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (2): 137-142.doi: 10.13418/j.issn.1001-165x.2023.2.04

三维可视化探究广泛性全子宫切除术后阴道轴向长期变化差异

卢逸嘉¹，陈春林¹ ，刘云鹭¹，冯婕²，刘萍¹*

南方医科大学南方医院 1.妇产科, 2.影像科，广州 510515

收稿日期:2022-03-31 出版日期:2023-03-25 发布日期:2023-04-11
通讯作者: 刘萍，教授，主任医师，博士生导师，E-mail：lpivy@ 126.com
作者简介:卢逸嘉（1996-），女，河南商丘人，硕士，研究方向：妇产科数字化解剖，女性盆底泌尿学，E-mail：1003970691@qq.com
基金资助:
广东省教育厅高水平大学建设经费南方医科大学临床研究启动项目（LC2016ZD019）；南方医科大学南方医院“临床研究专项”（2018CR030）

Explore the long-term axial changes of vagina after radical hysterectomy by three-dimensional visualization

Lu Yijia¹ , Chen Chunlin¹ , Liu Yunlu¹, Feng Jie² , Liu Ping1*

1.Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China; 2. Department of Imaging Center, Nanfang Hospital of Southern Medical, Guangzhou 510515, China University, Guangzhou 510515, China

Received:2022-03-31 Online:2023-03-25 Published:2023-04-11

摘要/Abstract

摘要： 目的通过MRI探究广泛性全子宫切除术(Radical hysterectomy,RH)前、术后1年及5年阴道轴向变化。方法选取2015年10月至2016年10月在南方医科大学南方医院接受RH的宫颈癌患者，分别于术前、术后1年及5年行MRI共纳入30例。通过Mimics 23.0软件将术前、后骨盆及阴道三维重建并置于同一空间，以术前、术后1年及5年阴道受力点为P1~P3，测量阴道长度、P1~P3处阴道夹角及坐标。结果 P2较P1角度增大（19.99±4.26）°、术后1年阴道缩短（5.55±0.6）cm，P3较P1角度增大（24.50±4.33）°、术后5年阴道缩短（5.95±1.13）cm，P3较P2角度增大（4.51±0.33）°、术后5年较1年阴道缩短（0.42±0.53）cm（P均<0.05）；P1坐标（3.19±0.69，1.59±0.52），P2（2.52±0.38，0.94±0.87），P3（2.39±0.46，0.69±0.59）。结论 RH术后阴道轴向夹角逐渐变钝、前倾，受力点向前更靠近耻骨联合、向下更靠近阴道口，这可能是其术后长期较少发生盆腔脏器脱垂原因之一。

关键词: 广泛性全子宫切除术； , , MRI；阴道轴向； , , 三维可视化研究； , , 骨盆倾斜校正

Abstract: Objective To explore the axial changes of vagina before, 1 year and 5 years after radical hysterectomy (RH) by MRI visualization. Methods A total of 30 cervical cancer patients who received RH in Nanfang Hospital of Southern Medical University from October 2015 to October 2016 underwent pelvic MRI examination 1 year and 5 years after operation respectively were included. Mimics 23.0 software was used to reconstruct the pelvis and vagina, the preoperative and posterior pelvis and vagina were matched and corrected by pelvic tilt correction system and placed in the same space. The axial stress points of vagina were named P1~P3 before surgery, 1 year and 5 years after surgery, respectively. The length of vagina, the angle and coordinates of upper and lower sections of P1~P3 were measured, and the differences of axial changes of vagina after operation were compared. Results The angle of P2 was (19.99±4.26) °higher than that of P1 and the vagina shortened by (5.55±0.6) cm one year after operation, The angle of P3 was (24.50±4.33)° higher than that of P1 and the vagina shortened by (5.95±1.13) cm five years after operation. The angle of P3 was (4.51±0.33) ° higher than that of P2, and the vagina was shortened (0.42±0.53) cm 5 years after surgery compared with 1 year after surgery (P<0.05). Stress point coordinates of P1 (3.19±0.69, 1.59±0.52), P2 (2.52±0.38, 0.94±0.87), P3 (2.39±0.46, 0.69±0.59). Conclusions After RH, the angle between the upper and lower segments of the vagina is gradually blunt and forward, and the force point is closer to the pubic symphysis in the forward direction and to the vaginal opening in the downward direction, which may be one of the reasons for the long-term rare occurrence of pelvic organ prolapse.

Key words: Radical hysterectomy; , MRI; , , Vaginal axial direction; , , 3D visualization research; , , Pelvic tilt correction

中图分类号:

R322.65

卢逸嘉, 陈春林, 刘云鹭, 冯婕, 刘萍 . 三维可视化探究广泛性全子宫切除术后阴道轴向长期变化差异[J]. 中国临床解剖学杂志, 2023, 41(2): 137-142.

Lu Yijia , Chen Chunlin , Liu Yunlu, Feng Jie , Liu Ping. Explore the long-term axial changes of vagina after radical hysterectomy by three-dimensional visualization[J]. Chinese Journal of Clinical Anatomy, 2023, 41(2): 137-142.

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三维可视化探究广泛性全子宫切除术后阴道轴向长期变化差异

Explore the long-term axial changes of vagina after radical hysterectomy by three-dimensional visualization

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