盆底二维超声结合三维超声断层成像在未育女性压力性尿失禁中的初步临床应用  

Clinical application of pelvic floor two-dimensional ultrasound combined with three-dimensional ultrasound tomography in stress urinary incontinence of nulliparous women

作　　者：胡海燕[1] 郭宏斌[1] 张静芳[1] 高明[1] 刘响玲 HU Hai-yan;GUO Hong-bin;ZHANG Jing-fang;GAO Ming;LIU Xiang-ling(Department of Ultrasound,the Second Affiliated Hospital of Xi'an Medical University,Xi'an 710038,Shaanxi,China)

机构地区：[1]西安医学院第二附属医院超声科,陕西西安710038

出　　处：《生物医学工程与临床》2022年第1期22-28,共7页Biomedical Engineering and Clinical Medicine

基　　金：陕西省重点研发计划项目(2019SF-051)。

摘　　要：目的探讨盆底二维超声结合三维超声断层成像(TUI)在未育女性压力性尿失禁(SUI)中的临床应用。方法选择2019年1月至2020年12月在西安医学院第二附属医院妇科门诊接诊有流产史未育SUI患者120例(试验组1),年龄21~38岁,平均年龄25.50岁;有流产史无SUI患者80例(试验组2),年龄21~38岁,平均年龄24.49岁;选择同期体检的健康女性50例(对照组),年龄21~38岁,平均年龄25.75岁。行盆底二维超声检查,观察在静息状态和Valsalva动作下膀胱颈、尿道内口形态变化、尿道内口是否有漏斗形成,记录膀胱逼尿肌厚度(DWT)、膀胱颈移动度(BND)、膀胱尿道后角(RA)及尿道旋转角(URA)变化;三维TUI检查,观察膀胱颈、尿道内口形态变化及盆膈裂孔解剖结构及形态学变化,统计膀胱尿道内口漏斗发生率。结果试验组1、试验组2、对照组在静息状态、Valsalva动作下膀胱DWT、膀胱RA、BND、URA比较(静息状态,DWT:4.93 mm±0.39 mm vs 3.38 mm±0.35 mm vs 2.49 mm±0.30 mm;RA:158.70°±5.70°vs 121.40°±5.10°vs 92.50°±4.50°;BND:29.60°±3.30°vs 17.70°±3.00°vs 12.50°±2.70°;URA:78.40°±4.50°vs57.80°±4.20°vs 32.20°±3.70°。Valsalva动作下,DWT:5.02 mm±0.50 mm vs 3.42 mm±0.48 mm vs 2.54 mm±0.39 mm;RA:160.60°±6.60°vs 122.40°±6.20°vs 93.50°±5.50°;BND:30.50°±3.40°vs 18.60°±3.20°vs 12.90°±2.80°;URA:79.60°±4.80°vs 58.90°±4.30°vs 33.20°±3.20°),差异有显著统计学意义(P <0.01)。静息状态及Valsava动作下试验组1的DWT、RA、BND、URA高于试验组2、对照组(P <0.05),试验组2的DWT、RA、BND、URA高于对照组(P <0.05)。各组在静息状态、收缩肛门运动、Valsalva动作下盆膈裂孔面积、前后径、左右径及肛提肌厚度比较,差异有显著统计学意义(P <0.01);静息状态、收缩肛门运动及Valsava动作下试验组1盆膈裂孔面积、前后径、左右径及肛提肌厚度高于试验组2、对照组(P <0.05),试验组2盆膈裂孔面积、前后径�Objective To explore the clinical application of pelvic floor two-dimensional ultrasound combined with three-dimensional tomographic ultrasound imaging(TUI) in stress urinary incontinence(SUI) of nulliparous women. Methods From January 2019 to December 2020, 120 cases of nulliparous SUI patients with abortion history(experimental group 1, which aged 21-38 years old with mean age of 25.50 years old), 80 patients of non-SUI with abortion history(experimental group 2,which aged 21-38 years old with mean age of 24.49 years old) were enrolled. Fifty healthy women were set as control group,which aged 21-38 years old with mean age of 25.75 years old. Two-dimensional pelvic floor ultrasonography was performed to observe morphological changes of bladder neck, urethral orifice as well as funnel formation of urethral orifice in resting state and Valsalva action, the changes of detrusor muscle thickness(DWT), bladder neck mobility(BND), bladder posterior urethral angle(RA) and urethral rotation angle(URA) were recorded. Three-dimensional TUI examination was performed to observe morphological changes of bladder neck and urethral orifice, anatomical and morphological changes of pelvic diaphragmatic hiatus, the incidence of funnel of bladder. In addition, urethral orifice was calculated. Results There were statistically significant difference in experimental group 1, experimental group 2 and control group under resting state and Valsalva action of DWT, RA, BND, URA(resting state, DWT: 4.93 mm ± 0.39 mm vs 3.38 mm ± 0.35 mm vs 2.49 mm ± 0.30 mm;RA: 158.70° ±5.70° vs 121.40° ± 5.10° vs 92.50° ± 4.50°;BND: 29.60° ± 3.30° vs 17.70° ± 3.00° vs 12.50° ± 2.70°;URA: 78.40° ± 4.50°vs 57.80° ± 4.20° vs 32.20° ± 3.70°. Valsalva action, DWT: 5.02 mm ± 0.50 mm vs 3.42 mm ± 0.48 mm vs 2.54 mm ± 0.39 mm;RA: 160.60° ± 6.60° vs 122.40° ± 6.20° vs 93.50° ± 5.50°;BND: 30.50° ± 3.40° vs 18.60° ± 3.20° vs 12.90° ± 2.80°;URA:79.60° ± 4.80° vs 58.90° ± 4.30° vs 33.20° ± 3.20°)(P < 0.01). Com

关 键 词：压力性尿失禁 未育 二维超声 三维超声断层成像 盆底 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.59[医药卫生—诊断学]