针灸治疗轻中度压力性尿失禁的盆底四维超声指标动态变化  

Dynamic Changes of Pelvic Floor Four-dimensional Ultrasound Indexes in Acupuncture Treatment of Mild to Moderate Stress Urinary Incontinence

作　　者：穆靓[1] 李佩佩[1] 陈娟[1] 徐姣姣[1] 刘玮 祁杰[1] 刘莉[1] MU Liang;LI Peipei;CHEN Juan;XU Jiaojiao;LIU Wei;QI Jie;LIU Li(Shaanxi Provincial People’s Hospital,Xi’an 710068,China;不详)

机构地区：[1]陕西省人民医院,陕西西安710068

出　　处：《中外医学研究》2022年第24期60-63,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：陕西省卫生健康科研基金项目(2018B002);陕西省卫生健康科研基金项目(2021D028);陕西省中医药管理局科研课题项目(2019—GJ—QT004);陕西省重点研发计划项目(2021SF—199)。

摘　　要：目的:盆底四维超声观察轻中度压力性尿失禁(SUI)女性针灸治疗前后肛提肌裂孔解剖结构及功能变化,并根据尿失禁影响问卷简表(IIQ-7)评分分析患者治疗后生活质量的改善。方法:选取2020年1月-2021年12月在陕西省人民医院泌尿外科定期检查的轻中度SUI女性48例,针灸治疗1个疗程,治疗前后超声测量女性患者在静息状态、缩肛动作和Valsalva动作3种状态下的肛提肌裂孔面积,以及Valsalva动作后膀胱颈移动度,治疗前后泌尿外科医生指导患者填写IIQ-7。结果:盆底四维超声显示:轻中度SUI患者治疗后缩肛动作时肛提肌裂孔面积小于治疗前,治疗后Valsalva动作后膀胱颈移动度小于治疗前,差异均有统计学意义(P<0.05);轻中度SUI患者治疗后静息状态及Valsalva动作时肛提肌裂孔面积与治疗前比较,差异均无统计学意义(P>0.05)。轻中度SUI患者治疗后IIQ-7评分较治疗前下降,差异有统计学意义(P<0.05)。结论:盆底四维超声显示,轻中度SUI女性针灸治疗后,缩肛动作时肛提肌裂孔面积缩小,盆底肌收缩功能提高,患者生活质量得以改善。Objective:To investigate the anatomical structure and dynamic function of levator ani hiatus in women with mild to moderate stress urinary incontinence(SUI)before and after acupuncture by pelvic floor four-dimensional ultrasound.According to the incontinence impact questionnaire short form(IIQ-7)score,to analyze the improvement of quality of life after treatment.Method:From January 2020 to December 2021,48 women with mild to moderate SUI in the Department of Urology of Shaanxi Provincial People’s Hospital were selected for one course of acupuncture.The levator ani hiatus area of female patients was measured by ultrasound before and after treatment in three states:resting state,anal constriction and Valsalva action,bladder neck movement after the Valsalva action,and the urological surgeon instructed the patients to fill out IIQ-7 before and after treatment.Result:Pelvic floor four-dimensional ultrasound showed that:the area of levator ani hiatus in patients with mild to moderate SUI during anal constriction after treatment was smaller than that before treatment,the bladder neck movement after Valsalva action after treatment was less than that before treatment,and the differences were statistically significant(P<0.05);but there were no significant differences in the areas of levator ani hiatus at rest and Valsalva action before and after treatment(P>0.05).The IIQ-7 score of patients with mild to moderate SUI after treatment decreased compared with that before treatment,and the difference was statistically significant(P<0.05).Conclusion:Pelvic floor four-dimensional ultrasound showes that after acupuncture treatment for women with mild to moderate SUI,the area of levator ani hiatus during anal constriction decreases,the contractive function of pelvic floor muscle improves,and the quality of life of patients improves.

关 键 词：四维超声 针灸 压力性尿失禁 肛提肌裂孔 

分 类 号：R246.3[医药卫生—针灸推拿学]