三维经会阴超声对绝经后女性压力性尿失禁患者行无张力阴道吊带术的疗效评价  

Evaluation of the effect of three-dimensional perineal ultrasound on TVT-O in postmenopausal women with stress urinary incontinence

作　　者：张静芳[1,2] 胡海燕[2] 李梅梅[2] 刘保民 ZHANG Jing -fang;HU Hai -yan;LI Mei - mei;LIU Bao - min(Department of Ultrasound, Second Affiliated Hospital of Xi~an Jiaotong University, Xi~an Shaanxi 710004, P. R. China;Department of Ultrasound, the Second Affiliated Hospital of Xi~an Medical University,Xi＇an Shaanxi 710038 ,P. R. China)

机构地区：[1]西安交通大学第二附属医院超声医学科,陕西西安710004 [2]西安医学院第二附属医院超声科,陕西西安710038

出　　处：《中国计划生育和妇产科》2017年第11期63-66,70,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：陕西省西安医学院自然科学重点资助计划项目(项目编号:16KY0104)

摘　　要：目的研究三维经会阴超声对绝经后女性压力性尿失禁(stress urinary incontinence,SUI)患者行无张力阴道吊带术(tension-free viginal tape-obturator system,TVT-O)手术前后膀胱和尿道超声参数变化,评价其临床价值。方法选取西安医学院第二附属医院2014年6月至2016年6月收治的绝经后SUI患者42例为研究组,以同年龄段健康体检者42例为对照组。两组在静息和Valsalva状态(令患者行强力闭呼动作)下行超声检查,观察、测量两组患者膀胱颈活动度、膀胱尿道后角和尿道角等参数;SUI患者TVT-O后再次行超声检查,并与术前和对照组的超声参数分别进行比较。结果 TVT-O术后研究组临床治疗有效率为95.2%;研究组手术前膀胱颈活动度、膀胱尿道后角、尿道角与对照组比较差异有统计学意义(t=27.32、7.76、9.09,P<0.05);研究组行TVT-O手术后的膀胱颈活动度和膀胱尿道后角比手术前缩小,尿道角与术前相比增大,各指标与术前比较差异有统计学意义(t=28.41、6.74、8.68,P<0.05);研究组手术后膀胱颈活动度、膀胱尿道后角、尿道角与对照组比较差异无统计学意义(t=1.92、0.89、1.55,P>0.05)。结论三维经会阴超声对于TVT-O术中吊带位置的确定有重要作用,为临床治疗效果的评价提供形态学依据。Objective To study the changes of bladder and urethral ultrasonography parameters before and after tension free vaginal tape obturator （TVT - O ） in postmenopausal women with stress urinary incontinence by three - dimensional perineal uhrasonography and evaluate its clinical value. Methods 42 patients with stress urinary incontinence （SUI） in Second Affiliated Hospital of Xitm Medical University from June 2014 to June 2016 were selected as the study group,while 42 cases of healthy women in the same age group were selected as the control group. The two groups were in the resting and Valsalva state （making the patient line a strong closed call） during the ultrasound examination. The bladder neck activity, bladder urethral posterior angle and urethral angle were observed and measured. SUI patients with TVT - O had uhrasound examination again, and compared with the preoperative and control group of ultrasound parameters. Results After TVT - O, clinical treatment effective rate of study group was 95.2 % ; There were significant differences in bladder activity, bladder urethral angle and urethral angle compared with control group （ t = 27.32, 7.76,9.09, P 〈 0.05 ）. In the study group, the bladder neck activity and bladder urethral posterior angle after TVT- O were smaller than those before operation, and the urethral angle increased compared with that before operation. There were significant differences between each index and preoperative comparison （t = 28.41,6. 74,8. 68 ,P 〈 0.05）. There were no significant differences in bladder activity, bladder urethral angle and urethral angle compared with control group（t = 1.92,0. 89,1.55,P 〉 0.05 ）. Conclusion Three -dimensional perineal ultrasonography plays an important role in the determination of the position of the sling in TVT - O, and provides the morphological basis for the evaluation of clinical therapeutic effect.

关 键 词：压力性尿失禁 三维超声 会阴超声 TVT-O术 治疗效果 

分 类 号：R694.54[医药卫生—泌尿科学]