三维超声早期诊断未孕未育女性尿失禁的应用  

Application of three-dimensional ultrasound in early diagnosis of urinary incontinence in non-pregnant nulliparous women

作　　者：姚彩 刘燕娜[1] 叶艳艳[1] 王继伟[1] YAO Cai;LIU Yanna;YE YanyanWANG Jiwei(The Second Af filiated Hospital of Nanchang University,Jiangxi Nanchang 330000,China)

机构地区：[1]南昌大学第二附属医院,江西南昌330000

出　　处：《中国妇幼健康研究》2021年第6期860-867,共8页Chinese Journal of Woman and Child Health Research

基　　金：江西省卫生计生委科技计划资助项目(20175248);江西省卫生计生委科技计划资助项目(20195246)。

摘　　要：目的拟为辅助临床早期诊断未孕未育女性尿失禁(UI)推荐便捷、可靠且客观的超声评估技术。方法将2018年11月至2019年11月在南昌大学第二附属医院行超声检查的未孕未育女性,依据有无漏尿史及国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)分为UI组(36例)及正常组(104例)。比较:(1)两组三维盆底超声参数;(2)Omniview-VCI和Render两种三维超声技术测量未孕未育女性肛提肌裂孔面积的一致性、重复性及耗时情况;(3)两种技术测量肛提肌裂孔面积诊断未孕未育女性UI的受试者工作曲线(ROC)。结果 (1)Omniview-VCI和Render技术测得UI组女性在瓦氏动作后的肛提肌裂孔面积均大于正常组(t值分别为10.100、10.360,P<0.05)。(2)操作者内部及不同操作者间重复性分析显示,Omniview-VCI和Render技术测量静息及瓦氏动作下未孕未育女性肛提肌裂孔面积的平均值差异小(平均值差异=-0.086~0.045,P>0.05),相关系数显示为极强相关(皮尔森相关系数r=0.876~0.959,P<0.05)且复测信度高(ICC=0.876~0.959,>0.80),说明两种技术测量未孕未育女性肛提肌裂孔面积在同一操作者内部、不同操作者间均有较好的可重复性;Omniview-VCI和Render技术间的一致性分析显示,两种技术在测量静息状态及瓦氏动作下未孕未育女性肛提肌裂孔面积的平均值差异小(平均值差异=-0.053~-0.026,P>0.05)、相关系数显示为极强相关(皮尔森相关系数r=0.899~0.976,P<0.05)且复测信度高(ICC=0.899~0.976,>0.80),说明一致性好;Omniview-VCI技术测量未孕未育女性肛提肌裂孔面积的耗时均短于Render技术(t=-121.217~-39.073,P<0.05)。(3)Omniview-VCI与Render技术诊断未孕未育女性UI的瓦氏动作下肛提肌裂孔面积临界值分别为14.55cm2、14.65cm2,诊断的敏感度分别为91.70%、88.90%,特异度分别为83.70%、84.60%。结论 (1)两种三维技术均可用于测量未孕未育女性肛提肌裂孔面积,且Omniview-VCI操作更高效;(Objective To recommend a convenient, reliable and objective ultrasound assessment technique for the clinical assistant diagnosis of urinary incontinence(UI) in non-pregnant nulliparous women.Methods Non-pregnant nulliparous women who underwent ultrasound examination in the Second Affiliated Hospital of Nanchang University from November 2018 to November 2019 were divided into UI group(36 cases) and normal group(104 cases) according to the history of urine leakage and the International Consultation on Incontinence Questionnaire-Short Form(ICI-Q-SF).The following indexes were compared:(1) three-dimensional(3 D) ultrasonic parameters of pelvic floor between the two groups;(2) the consistency, repeatability and time-consuming of measuring the area of levator ani hiatus in non-pregnant nulliparous women by Omniview-VCI and Render;(3) receiver operating curve(ROC) curve of for diagnosing UI in non-pregnant nulliparous women by measuring the area of levator ani hiatus using two techniques.Results(1) Omniview-VCI and Render techniques showed that the area of levator ani hiatus after Valsalva maneuver in UI group was larger than that in normal group(t values were 10.100 and 10.360,respectively, both P<0.05).(2) The internal and inter-operator repetitiveness analysis showed that the Omniview-VCI and Render techniques had little difference in the mean size of the area of levator ani hiatus in non-pregnant nulliparous women at rest and under Valsalva maneuver(mean differences ranged from-0.086 to 0.045,all P>0.05),the correlation coefficient showed strong correlation [Pearson′s correlation coefficients(r) ranged from 0.876 to 0.959,all P<0.05],and high retest reliability(ICC ranged from 0.876 to 0.959, ICC>0.80),indicating that the two techniques had good repeatability in the same operator and between different operators in measuring the area of levator ani hiatus in non-pregnant nulliparous women.Consistency analysis between the Omniview-VCI and Render techniques showed that the mean differences in the area of levator ani

关 键 词：未孕未育女性 尿失禁 肛提肌裂孔面积 三维超声 Omniview-VCI技术 Render技术 

分 类 号：R711.59[医药卫生—妇产科学] R445.1[医药卫生—临床医学]