经阴道三维超声结合POP-Q评分对盆腔器官脱垂盆底重建术前隐匿性压力性尿失禁的诊断价值  

Diagnostic value of transvaginal three-dimensional ultrasound combined with POP-Q score in the diagnosis of occult stress urinary incontinence before pelvic floor reconstruction for pelvic organ prolapse

作　　者：孙璐璐 吴宏匀 陶芸飞 陈晶晶[2] 李秋维 叶莺 SUN Lulu;WU Hongyun;TAO Yunfei;CHEN Jingjing;LI Qiuwei;YE Ying(Department of Ultrasound,Rugao Hospital of Traditional Chinese Medicine,Jiangsu Province,Rugao226500,China;Department of Gynecology,Rugao Hospital of Traditional Chinese Medicine,Jiangsu Province,Rugao226500,China;Department of Ultrasound,Affiliated Hospital of Nantong University,Jiangsu Province,Rugao226001,China)

机构地区：[1]江苏省如皋市中医院超声科,江苏如皋226500 [2]江苏省如皋市中医院妇科,江苏如皋226500 [3]江苏省南通大学附属医院超声科,江苏如皋226001

出　　处：《中国医药导报》2023年第10期138-141,共4页China Medical Herald

基　　金：江苏省“333工程”科研资助项目(BRA2017175)。

摘　　要：目的探讨经阴道三维超声结合盆腔器官脱垂定量分期法(POP-Q)评分对盆腔器官脱垂(POP)盆底重建术前隐匿性压力性尿失禁(OSUI)的诊断价值。方法回顾性分析2020年8月至2022年3月江苏省如皋市中医院收治的72例行POP盆底重建术患者的临床资料,根据尿动力学分为合并OSUI组(合并组,38例)和未合并OSUI组(未合并组,34例)。两组术前均行经阴道三维超声、POP-Q评分检查,分析经阴道三维超声相关参数及POP-Q评分对POP盆底重建术前OSUI的诊断价值。结果合并组静息时肛提肌裂孔面积(R-ALH)、Valsalva动作时肛提肌裂孔面积(V-ALH)、尿道旋转角(UR)、膀胱颈移动度(BND)高于未合并组(P<0.05)。两组距处女膜3 cm的阴道前臂处(Aa)、阴道前臂脱离处女膜的最远端(Ba)提示点比较,差异有统计学意义(P<0.05)。R-ALH、V-ALH、UR、BND联合Aa、Ba提示点诊断POP盆底重建术前OSUI的曲线下面积高于各项单独检测(P<0.05)。结论R-ALH、V-ALH、UR、BND及Aa、Ba提示点对POP盆底重建术前OSUI具有一定的诊断价值。Objective To investigate the diagnostic value of transvaginal three-dimensional ultrasound combined with pelvic organ prolapse quantitative staging(POP-Q)score in the diagnosis of occult stress urinary incontinence(OSUI)before pelvic floor reconstruction for pelvic organ prolapse(POP).Methods A retrospective analysis of the clinical data of 72 patients with pelvic floor reconstruction for POP who were admitted to Rugao Traditional Chinese Medicine Hospital in Jiangsu Province from August 2020 to March 2022.According to urodynamics,they were divided into combined with OSUI group(combined group,38 cases)and uncombined OSUI group(uncombined group,34 cases).Both groups underwent transvaginal three-dimensional ultrasonography and POP-Q score before operation.The diagnostic value of transvaginal three-dimensional ultrasound-related parameters and POP-Q score in the diagnosis of OSUI before pelvic floor reconstruction for POP were analyzed.Results The rest area of the levator hiatus(R-ALH),Valsalva area of the levator hiatus(V-ALH),urethral rotation angle(UR),and bladder neck mobility(BND)in combined group were higher than those in the uncombined group(P<0.05).There were significant differences in cue points at the forearm of the vagina 3 cm from the hymen(Aa)and the furthest part of the forearm of the vagina from the hymen(Ba)between two groups(P<0.05).The AUC value of R-ALH,V-ALH,UR,BND,combined with cue points at Aa and Ba in the diagnosis of OSUI before pelvic floor reconstruction for POP was higher than that of each individual test(P<0.05).Conclusion The R-ALH,V-ALH,UR,BND,and cue points at Aa and Ba have certain diagnostic value for OSUI before pelvic floor reconstruction for POP.

关 键 词：经阴道三维超声 隐匿性压力性尿失禁 盆腔器官脱垂 盆腔器官脱垂定量分期法 盆底重建术 

分 类 号：R737.3[医药卫生—肿瘤]