超声评估膀胱脱垂分型与女性压力性尿失禁的相关性研究  

Correlation between stress urinary incontinence and cystocele type by transperineal ultrasound

作　　者：卜岚[1] 聂芳[1] 杨丹[1] 车岩[1] 高峻[1] 

机构地区：[1]兰州大学第二医院,甘肃兰州730030

出　　处：《中国临床医学影像杂志》2017年第11期814-816,821,共4页Journal of China Clinic Medical Imaging

基　　金：兰州市科技计划项目(项目编号:2016-2-71)

摘　　要：目的:探讨经会阴超声评估膀胱脱垂分型与女性压力性尿失禁之间的相关性。方法 :对经临床或尿动力学证实的83例膀胱脱垂合并压力性尿失禁患者(SUI组)、78例膀胱脱垂不合并尿失禁患者(脱垂组)行会阴超声检查,测量在静息状态和最大Valsalva状态下膀胱颈及膀胱后壁最低点的位置、尿道倾斜角及膀胱尿道后角等指标,并计算膀胱颈及膀胱后壁最低点下降值及尿道旋转角等。81例正常体检女性为对照组。结果:SUI组与脱垂组分别诊断膀胱尿道膨出73例、37例,两组分别诊断孤立性膀胱膨出10例、41例,SUI组与脱垂组中膀胱脱垂的分型差异有统计学意义(P<0.05);不论在SUI组或脱垂组,其诊断的不同膀胱脱垂类型的膀胱颈下降值均无明显差异(P>0.05),而膀胱后壁最低点下降值、膀胱尿道后角及尿道旋转角有明显统计学差异(P<0.05);Valsalva动作后,SUI组、脱垂组分别与对照组进行对比,各超声测量指标均有统计学差异(P<0.05)。结论:经会阴超声能够诊断膀胱脱垂类型,不同膀胱脱垂类型的盆底解剖结构改变不同,其中膀胱尿道膨出与压力性尿失禁关系密切。Objective： To investigate the correlation of stress urinary incontinence（SUI） and cystocele type by transperineal ultrasound. Methods： A retrospective study evaluated 83 women with the diagnosis of eystocele with SUI （group SUI） and 78 women with the diagnosis of cystocele without SUI（group cystocele） that were confirmed by clinical and urodynamic study. The bladder neck, bladder back wall lowest point, the posterior urethrovesical angle （PUA）, the urethra inclination angle were ob- served by transperineal ultrasound at rest and Valsalva, and the bladder neck decent, bladder back wall lowest point decent and urethral rotation angle were calculated. Eighty-one normal women were enrolled as the control group. Results： Seventy- three patients were diagnosed cystourethroeele and 10 were diagnosed isolated cystoeele in group SUi, and 37 were diagnosed cystourethroeele and 41 were diagnosed isolated cystocele in group eystocele by transperineal ultrasound. The difference be- tween group SU[ and group eystocele in cystocele type was statistically significant （P〈0.05）. No matter in group SUI or group cystocele, the bladder neck descent was no difference in cystourethrocele and isolated eystocele in each group （P〉0.05）, but bladder back wall lowest point, PUA and urethral rotation angle were statistically significant in each group （P〈0.05）. All the parameters were statistically significant after Valsalva when group SUI, group cystocele compared with control group （P〈0.05）. Conclusion： Cystocele type can be diagnosed by transperineal ultrasound. Different cystocele type had different pelvic floor anatomy, and cystourethroeele was closely related to SUI.

关 键 词：膀胱疾病 脱垂 尿失禁 压力性 超声检查 多普勒 彩色 

分 类 号：R694.54[医药卫生—泌尿科学] R445.1[医药卫生—外科学]