盆底超声测量前腔室结构参数在女性压力性尿失禁与膀胱脱垂诊断中的应用  

Application of pelvic floor ultrasound measurement of anterior compartment structural parameters in diagnosis of female stress urinary incontinence and bladder prolapse

作　　者：曹丽[1] 相泓冰[1] 杨静[1] Li Cao;Hongbing Xiang;Jing Yang(Department of Ultrasound Diagnosis,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院超声诊断科,473000

出　　处：《中国实用医刊》2021年第21期74-77,共4页Chinese Journal of Practical Medicine

摘　　要：目的探究盆底超声测量前腔室结构参数在女性压力性尿失禁(SUI)与膀胱脱垂诊断中的应用效果。方法回顾性分析2018年6月至2020年8月于南阳市中心医院进行产后复查的166例膀胱脱垂致SUI患者的临床资料。将其中95例膀胱脱垂临床分度Ⅰ~Ⅱ度者纳入轻中度脱垂组,71例膀胱脱垂临床分度Ⅲ度者纳入重度脱垂组。比较两组盆底超声测量前腔室结构参数(膀胱颈位置、膀胱后角、膀胱颈移动度、尿道旋转角)及漏尿量;分析膀胱颈位置、膀胱后角、膀胱颈移动度、尿道旋转角与膀胱脱垂临床分度、漏尿量的相关性;采用受试者工作特征曲线(ROC)评估膀胱颈位置、膀胱后角、膀胱颈移动度、尿道旋转角对膀胱脱垂严重程度的诊断效能。结果重度脱垂组膀胱颈位置低于轻中度脱垂组(P<0.05),重度脱垂组膀胱后角、膀胱颈移动度、尿道旋转角、漏尿量均大于轻中度脱垂组(P均<0.05)。Spearman相关性分析结果表明,膀胱脱垂临床分度与膀胱颈位置呈负相关(P<0.05),与膀胱后角、膀胱颈移动度、尿道旋转角呈正相关(P<0.05)。Pearson相关性分析结果显示,漏尿量与膀胱颈位置呈负相关(P<0.05),与膀胱后角、膀胱颈移动度、尿道旋转角呈正相关(P<0.05)。膀胱颈位置、膀胱后角、膀胱颈移动度、尿道旋转角诊断膀胱脱垂临床分度的ROC曲线下面积分别为0.779、0.783、0.725、0.743;截断值分别为21.65 mm、131.19°、31.46 mm、46.19°;上述指标的ROC曲线下面积与参考线相比差异有统计学意义(P<0.05)。结论盆底超声测量前腔室结构参数在女性膀胱脱垂所致SUI诊断中的效能显著,其参数水平与患者膀胱脱垂分度、漏尿情况关系密切。Objective To investigate the application effect of pelvic floor ultrasound measurement of anterior compartment structural parameters in the diagnosis of female stress urinary incontinence(SUI)and bladder prolapse.Methods The clinical data of 166 patients with SUI caused by bladder prolapse who underwent postpartum review in Nanyang Central Hospital from June 2018 to August 2020 were retrospectively analyzed.Of them,95 patients with bladder prolapseclinical gradeⅠ-Ⅱwere allocated into mild-to-moderate prolapse group,and 71 patients with bladder prolapse gradeⅢwere allocated into severe prolapse group.The anterior compartment structural parameters by pelvic floor ultrasound measurement(bladder neck position,retrovesical angle,bladder neck mobility,urethral rotation angle)and urine leakage volume were compared between the two groups.The correlation between bladder neck position,retrovesical angle,bladder neck mobility,urethral rotation angle and clinical grade of bladder prolapse and urine leakage volume was analyzed.Receiver operating characteristic curve(ROC)was used to evaluate the diagnostic efficacy of bladder neck position,retrovesical angle,bladder neck mobility and urethral rotation angle on severity of bladder prolapse.Results The bladder neck position in severe prolapse group was lower than that in mild-to-moderate prolapse group(P<0.05),and the retrovesical angle,bladder neck mobility,urethral rotation angle and urine leakage volume in severe prolapse group were greater than those in mild-to-moderate prolapse group(P<0.05).Results of Spearman correlation analysis showed that the clinical grade of bladder prolapse was negatively correlated with bladder neckposition(P<0.05),and it was positively correlated with retrovesical angle,bladder neck mobility and urethral rotation angle(P<0.05).Results of Pearson correlation analysis showed that the urine leakage volume was negatively correlated with bladder neck position(P<0.05),and was positively correlated with retrovesical angle,bladder neck mobility and

关 键 词：压力性尿失禁 盆底超声 前腔室结构 膀胱脱垂 诊断 

分 类 号：R711.59[医药卫生—妇产科学] R694[医药卫生—临床医学]