女性产后压力性尿失禁诊断及预后评估的定量诊断方法研究  

Quantitative detection method for diagnosis and prognosis evaluation of postpartum stress urinary incontinence in women

作　　者：严静 钱陈凤 周一波[1] YAN Jing;QIAN Chen-feng;ZHOU Yi-bo(Department of Ultrasound Medicine,Jinhua Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院超声医学科,浙江金华321000

出　　处：《中华全科医学》2022年第3期454-457,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金项目(LSY19H180006)。

摘　　要：目的观察盆底超声及尿动力学检测用于女性产后压力性尿失禁诊断及预后评价的临床效果。方法选择2019年2月—2021年2月于金华市中心医院就诊并接受产后康复治疗的100例产后压力性尿失禁患者和同期300例产后正常女性为研究对象,所有研究对象均进行盆底超声检查及尿动力学检测,产后压力性尿失禁患者均进行盆底肌康复训练及生物反馈电刺激治疗,评价疗效水平,比较盆底超声相关参数及尿动力学指标差异情况。结果产后压力性尿失禁患者膀胱颈移动距离和尿道旋转角超声检测数值均显著高于产后正常女性(t=32.768、28.960,均P<0.001),产后压力性尿失禁患者尿道内漏斗形成率(88.00%)显著高于产后正常女性水平(11.33%,χ^(2)=207.965,P<0.001),且产后压力性尿失禁患者尿道最大闭合压力、功能性尿道长度和尿道最大压力等尿动力学检测参数均显著低于产后正常女性水平(均P<0.001);盆底肌康复训练及生物反馈电刺激治疗对于产后压力性尿失禁患者的总体治疗有效率为83.00%;康复治疗有效的产后压力性尿失禁患者膀胱颈移动距离和尿道旋转角超声检测数值均显著低于治疗无效患者(t=5.760、8.323,均P<0.001),且尿道内漏斗形成率(18.07%)显著低于治疗无效患者(76.47%,χ^(2)=21.060,P<0.001),各尿动力学指标均显著高于治疗无效患者(均P<0.001)。结论盆底超声及尿动力学检测可有效识别产后压力性尿失禁患者盆底组织结构和尿道生理功能变化,对产后压力性尿失禁的早期诊断和预后评估具有较高临床应用价值。Objective To observe the clinical effect of pelvic floor ultrasound and urodynamic test in the diagnosis and prognosis evaluation of female postpartum stress urinary incontinence.Methods One hundred cases of postpartum stress urinary incontinence patients and 300 cases of normal postpartum women were studied.All subjects were tested by pelvic floor ultrasound and urodynamics.The patients with postpartum stress incontinence were trained with pelvic floor muscle rehabilitation and biofeedback electrical stimulation to evaluate the efficacy level.The changes in pelvic floor ultrasound and urodynamic indexes between patients with postpartum stress incontinence and normal postpartum women and patients with different therapeutic levels were compared.Results The ultrasonic detection values of bladder neck movement distance and urethral rotation angle in patients with postpartum stress urinary incontinence were significantly higher than those in normal postpartum women(t=32.768,28.960;all P<0.001),the rate of intraurethral funnel formation in patients with postpartum stress urinary incontinence(88.00%)was significantly higher than that in normal postpartum women(11.33%,χ^(2)=207.965,P<0.001),and the urodynamic parameters such as maximum urethral closure pressure,functional urethral length and maximum urethral pressure in patients with postpartum stress urinary incontinence were significantly lower than those of normal postpartum women(all P<0.001).The total effective rate of floor muscle rehabilitation training and biofeedback electrical stimulation for patients with postpartum stress urinary incontinence was 83.00%.The pelvic floor ultrasound indexes of patients with postpartum stress urinary incontinence after effective rehabilitation treatment were significantly lower than those of patients with ineffective treatment(t=5.760,8.323;all P<0.001),the rate of intraurethral funnel formation(18.07%)was significantly lower than that of patients with ineffective treatment(76.47%,χ^(2)=21.060,P<0.001),and the urodynamic inde

关 键 词：产后压力性尿失禁 盆底超声 尿动力学检测 早期诊断 预后评价 

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