盆底超声评估经闭孔无张力尿道中段悬吊术治疗压力性尿失禁中吊带与治疗效果的关系  

The Relationship Between Transobturator Tension-free Midurethral Sling in the Treatment of Stress Urinary Incontinence and the Therapeutic Effect by Bottom Ultrasound Assessment

作　　者：朱韵 姜丽英[1] 胡萍 周勤 金清[1] Zhu Yun;Jiang Liying;Hu Ping;Zhou Qin;Jin Qing(Department of Ultrasound,Kunshan Hospital of Traditional Chinese Medicine,Kunshan,Jiangsu 215300,China)

机构地区：[1]昆山市中医医院超声科,江苏省昆山市215300

出　　处：《中国超声医学杂志》2023年第1期74-77,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 运用盆底超声对40例经闭孔无张力尿道中段悬吊带术的压力性尿失禁患者术后静息状态下与瓦氏动作后吊带位置、角度变化与疗效的关系进行评估。方法 选取40例行经闭孔无张力尿道中段悬吊带术的压力性尿失禁患者术后按临床疗效不同进行分组,20例临床治疗有效为观察组,20例临床治疗无效为对照组,并进行盆底实时超声检查,观察两组患者术后在静息状态下、瓦氏动作后吊带位置,并动态观察测量患者在静息状态下、瓦氏动作后吊带角度的变化,比较吊带位置及角度变化与预后的关系。结果 吊带中点距离尿道内口距离与有效尿道长度比值静息状态时观察组为0.732±0.078,对照组为0.453±0.092;瓦氏动作后观察组为0.712±0.033,对照组为0.445±0.077,无论是在静息状态时还是瓦氏动作后两组差异有统计学意义(P<0.05);吊带中心点至尿道中心点距离静息状态下观察组为(3.371±0.409)mm,对照组为(5.637±0.338)mm;与瓦氏动作后观察组为(3.154±0.378)mm,对照组为(5.939±0.293)mm;无论是在静息状态下还是瓦氏动作后两组差异均有统计学意义(P<0.05);静息状态下与瓦氏动作后吊带角度变化差值观察组为20.5°±10.213°,对照组为60.333°±5.132°,两组差异有统计学意义(P<0.05)。结论 盆底超声可以通过观察经闭孔无张力尿道中段悬吊带术后静息状态下与瓦氏动作后吊带位置、角度变化来评价治疗效果,并提供有价值的影像学依据。Objective To evaluate the relationship between the position and angle change of the sling and the curative effect at rest and after Valsalva maneuver in 40 patients with stress urinary incontinence who underwent transobturator tension-free middle urethral sling.Methods 40 patients with stress urinary incontinence who underwent transobturator tension-free mid-urethral sling were included and divided into groups according to different clinical efficacy post operation.Twenty patients with effective clinical treatment were included in the observation group,and 20 patients with ineffective clinical treatment were included in the control group.Real-time ultrasound examination of the pelvic floor was performed to observe the position of the sling in the resting state and after the Valsalva maneuver.Changes of the sling angle and the position of the sling of the patients in the resting state and after the Valsalva maneuver were also recorded.The relationship between angle change and prognosis was also evaluated.Results The ratio of the distance from the midpoint of the sling to the internal urethra to the effective urethral length in the resting state was 0.732±0.078 in the observation group and 0.453±0.092 in the control group;while after Valsalva maneuver was 0.712±0.033 in the observation group and 0.445±0.077 in the control group,the difference between the two groups was statistically significant both at resting state and after Valsalva maneuver(P<0.05).The distance from the center point of the sling to the center point of the urethra at resting state was(3.371±0.409) mm in the observation group and(5.637±0.338) mm in the control group;while after Valsalva maneuver,it was(3.154±0.378) mm in the observation group and(5.939±0.293) mm in the control group,the difference between the two groups was statistically significant both at resting state and after Valsalva maneuver(P<0.05).The difference between the angle change of the sling in the resting state and that after Valsalva maneuver was 20.5°±10.213° in the

关 键 词：盆底超声 压力性尿失禁 经闭孔阴道无张力尿道中段悬吊带术 吊带位置 角度变化 

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]