产后压力性尿失禁患者盆底超声参数分析及影响因素探讨  

Analysis of pelvic floor ultrasound parameters and influencing factors of postpartum stress urinary incontinence

作　　者：郑志燕 徐伟[2] 唐文成 冯小凤 常小霞 葛环 ZHENG Zhiyan;XU Wei;TANG Wencheng;FENG xiaofeng;CHANG Xiaoxia;GE Huan(Department of Ultrasound,Chuzhou Hospital Affiliated to Anhui Medical University,Chuzhou 239200,China;Department of Imaging,Chuzhou Hospital Affiliated to Anhui Medical University,Chuzhou 239200,China;Department of Gynaecology and Obstetrics,Chuzhou Hospital Affiliated to Anhui Medical University,Chuzhou 239200,China;Department of Gynaecology and Obstetrics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]安徽医科大学附属滁州医院/滁州第一人民医院超声科,安徽滁州239200 [2]安徽医科大学附属滁州医院/滁州第一人民医院影像科,安徽滁州239200 [3]安徽医科大学附属滁州医院/滁州第一人民医院妇产科,安徽滁州239200 [4]南京医科大学第一附属医院/江苏省人民医院/江苏省妇幼保健院妇女保健科,江苏南京210029

出　　处：《安徽医学》2024年第2期152-157,共6页Anhui Medical Journal

基　　金：江苏省老年健康科研项目(编号:LKZ2022013)。

摘　　要：目的 分析产后6周女性压力性尿失禁(SUI)患者的盆底超声参数,结合临床因素,探索其影响因素。方法 回顾性分析2022年3月至2023年4月于安徽医科大学附属滁州医院进行规范化产检、分娩及产后6周复查盆底超声的152例患者资料,根据是否发生产后SUI分为SUI组(64例)和非SUI组(88例),分析两组研究对象盆底超声参数和临床因素的不同,构建logistic多因素回归方程探索产后SUI的独立危险因素。结果 SUI组和非SUI组在产次、妊娠期漏尿症状、妊娠期糖尿病方面比较,差异均有统计学意义(P<0.05),在膀胱颈移动度、尿道旋转角、膀胱尿道后角、尿道内口漏斗形成情况、肛提肌裂孔面积方面比较,差异亦有统计学意义(P<0.05)。多因素logistic回归分析发现,膀胱颈移动度(OR=1.284,95%CI:1.134~1.454,P<0.001)、尿道内口漏斗形成(OR=5.475,95%CI:1.335~22.459,P=0.018)和妊娠期漏尿症状(OR=8.838,95%CI:2.229~35.037,P=0.002)是产后6周女性SUI的独立危险因素。结论 产后6周女性SUI的独立危险因素为膀胱颈移动度、尿道内口漏斗形成和妊娠期漏尿症状,临床应尽早制定合理的治疗方案,指导预后,提高女性生活质量。Objective To explore the independent influencing factors causing stress urinary incontinence in women 6 weeks postpartum.Methods Retrospective analysis was performed on the clinical data of 152 patients who underwent standardized prenatal examination,delivery,and 6-week postpartum pelvic floor ultrasound re-examination at Chuzhou Hospital Affiliated to Anhui Medical University from March 2022 to April 2023.According to whether there was postnatal SUI,they were divided into the SUI group (64 cases) and non SUI group(88 cases).The differences in pelvic floor three-dimensional ultrasound parameters and clinical factors between the two groups were analyzed,and factors with P<0.10 were included in the difference comparison to construct a logistic multiple factor regression equation to explore independent risk factors for postpartum stress urinary incontinence.The difference was statistically significant with P<0.05.Results There was no statistical difference between the SUI group and the non SUI group in age,prenatal BMI,six week postpartum BMI,newborn weight,delivery mode,and whether there was hypertension during pregnancy (P>0.05),but there was statistical difference in the number of births,the symptoms of urine leakage during pregnancy,and diabetes during pregnancy (P<0.05).There was no significant difference between the SUI group and non SUI group in detrusor thickness,residual urine volume,and initial position of bladder neck (P>0.05),but there were significant differences in the movement of bladder neck,urethral rotation angle,posterior angle of bladder and urethra,funnel formation of internal urethral orifice of urethra,and area of levator ani tear (P<0.05).Multivariate regression analysis found that the degree of bladder neck movement,funnel formation at the internal urethral orifice and urine leakage during pregnancy were independent risk factors for postpartum SUI at six weeks.The greater the degree of bladder neck movement,the higher the risk of postpartum SUI,with statistical significance (OR=1.284,95%CI:1

关 键 词：压力性尿失禁 盆底超声 膀胱颈移动度 尿道内口漏斗形成 漏尿 妊娠期糖尿病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.6[医药卫生—诊断学]