中国正常已育女性尿道活动度的前瞻性多中心横断面研究  

A prospective multi-center cross-sectional study of urethral mobility in normal parous women in China

作　　者：吴双玉 陈莹[1] 王琨[2] 朱慧欢 冉素真[4] 韦爱华[5] 徐英姿[6] 王旭东[7] 田家玮[7] 张新玲[1] Wu Shuangyu;Chen Ying;Wang Kun;Zhu Huihuan;Ran Suzhen;Wei Aihua;Xu Yingzi;Wang Xudong;Tian Jiawei;Zhang Xinling(Department of Ultrasound,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Ultrasound,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China;Department of Ultrasound,Zhongshan People′s Hospital,Zhongshan 528400,China;Department of Ultrasound,Chongqing Maternal and Child Health Hospital,Chongqing 401147,China;Ultrasound Diagnosis Center,Shaanxi Provincial People′s Hospital,the Third Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710068,China;Department of Ultrasound,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China;Department of Ultrasound,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]中山大学附属第三医院超声科,广州510630 [2]广州医科大学附属第三医院超声医学科,510150 [3]中山市人民医院超声科,528400 [4]重庆市妇幼保健院超声科,401147 [5]陕西省人民医院西安交通大学第三附属医院超声科,西安710068 [6]浙江省立同德医院超声科,杭州310012 [7]哈尔滨医科大学附属第二医院超声医学科,150086

出　　处：《中华超声影像学杂志》2021年第4期299-305,共7页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(91859115)。

摘　　要：目的探讨经会阴超声评估正常已育女性尿道活动度以及相关危险因素对尿道活动度的影响。方法收集2017年2月至2018年8月就诊于全国37家三甲医院且符合纳入标准的女性,所有受检者均进行了规范化的经会阴超声检查并测量尿道旋转角(urethral rotation angle,URA)、最大Valsalva状态下膀胱颈位置(bladder neck position at maximum Valsalva maneuver,BNP-V)及膀胱颈移动度(bladder neck descent,BND)。采用问卷的形式采集受检者的年龄、身高、体重、体质指数(body mass index,BMI)、既往史、孕产史以及尿失禁相关病史等基本信息。采用Mann-WhitneyU检验和多元线性回归分析探讨年龄、BMI、分娩方式及分娩次数对正常已育女性尿道活动度的影响,据此对入组的女性进行分组,同时给出相应的URA、BNP-V及BND数据分布范围。结果与BMI正常且既往无阴道分娩史的已育女性相比,超重和(或)既往有阴道分娩史的女性,其URA及BND更大(P<0.05)。URA及BND在不同剖宫产次数组间差异无统计学意义(P>0.05);而随着阴道分娩次数的增加,URA及BND随之增大(P<0.05)。结论BMI和阴道分娩是影响正常已育女性尿道活动度的重要危险因素,随着BMI的增加及阴道分娩次数的增加,尿道活动度也随之增大。Objective To assess the urethral mobility of normal parous women in China and explore the impacts of related risk factors on it using translabial ultrasound.Methods Females who met the inclusion criteria in 37 tertiary hospitals from February 2017 to August 2018 were included.All women underwent standardized translabial ultrasound examination and the urethral rotation angle(URA),bladder neck position at maximum Valsalva maneuver(BNP-V)and bladder neck descent(BND)were measured.Questionnaires were used to collect basic information including age,height,weight,body mass index(BMI),past medical history,maternity history,and urinary incontinence related history.Mann-Whitney U test and multiple linear regression analysis were adopted to explore the influences of age,BMI,delivery mode and parity on normal parous women′s urethral mobility.Then,the study subjects were divided into different groups and the corresponding values of URA,BNP-V and BND were compared.Results Compared with parous women with normal BMI and no history of vaginal delivery,those who were overweight and/or had a history of vaginal delivery were more likely to gain greater URA and BND(P<0.05).The URA and BND were not significantly different between women with different times of cesarean sections(P>0.05);while for women with a history of vaginal delivery,these two parameters increased with the increase of the number of transvaginal deliveries(P<0.05).Conclusions BMI and vaginal delivery are important risk factors for the urethral mobility of normal parous women.The urethral mobility increases with the increase of BMI and the number of vaginal deliveries.

关 键 词：超声检查 经会阴 盆底 尿道活动度 体质指数 阴道分娩 

分 类 号：R695[医药卫生—泌尿科学]