经会阴智能盆底超声在PFD产妇产后压力性尿失禁筛查中的应用  

Application of transperineal intelligent pelvic floor ultrasound in screening of postpartum stress urinary incontinence in women with pelvic floor dysfunction

作　　者：路姗姗 王春丽 苏洁 赵红敏 李纳 李宁 Lu Shanshan;Wang Chunli;Su Jie;Zhao Hongmin;Li Na;Li Ning(Departmens of Ultrasound,Yihe Hospital of Cangzhou People's Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市人民医院颐和院区超声医学科,沧州061000

出　　处：《国际泌尿系统杂志》2024年第3期509-513,共5页International Journal of Urology and Nephrology

基　　金：沧州市科技计划项目自筹经费项目(204106004)。

摘　　要：目的:探究经会阴智能盆底超声在盆底功能障碍性疾病(PFD)产妇产后发生压力性尿失禁(SUI)筛查中的应用价值。方法:选择2020年1月至2021年8月本院收治的90例产后发生SUI的PFD产妇作为研究对象,根据分娩方式分为经阴道产组(42例)和剖宫产组(48例),另选同期于本院体检的45例健康已婚未孕者作为对照组。比较两种检查方法中三组受检者分别在静息状态、Vasalva动作状态、肛提肌收缩状态下的肛提肌裂孔长度及面积;分析智能盆底超声、MRI分别与金标准诊断的一致性;采用受试者工作特征(ROC)曲线评估两种方法的诊断效能。结果:在静息状态、Vasalva动作状态及肛提肌收缩状态下,两种检查方法中三组患者的肛提肌裂孔长度及面积比较,差异均具有统计学意义(均P<0.05);智能盆底超声、MRI与金标准诊断的一致性较强,准确率分别为95.56%和93.33%;经会阴智能盆底超声检查的灵敏度、特异度、ROC曲线下面积(AUC)分别为95.28%、64.76%和0.827,明显高于MRI(89.72%、58.75%和0.782)(均P<0.05)。结论:经会阴智能盆底超声与MRI均能够较准确地评估PFD产妇产后的SUI发生情况,但前者具有更高的诊断价值。Objective To explore the application value of transperineal smart pelvic ultrasound in the screening of stress urinary incontinence(SUI)in women with pelvic floor dysfunction disease(PFD).Methods The 90 cases of PFD women with postpartum SUI admitted to our hospital from January 2020 to August 2021 were selected as the research objects.According to the delivery method,they were divided into vaginal delivery group(42 cases)and cesarean section group(48 cases).Forty-five healthy,married,non-pregnant individuals who were undergoing physical examinations in our hospital during the same period were selected as the control group.The length and area of the hiatus of levator anal muscle in the resting state,Vasalva action state and contraction state of levator anal muscle were compared in the three groups of the two methods.The consistency of intelligent pelvic floor ultrasound and MRI with gold standard diagnosis was analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of the two methods.Results In the resting state,Vasalva action state and anal levator contraction state,there were statistically significant differences in the length and area of anal levator hiatus among the three groups(all P<0.05).The diagnostic accuracy of smart pelvic floor ultrasound and MRI was 95.56%and 93.33%,respectively.The sensitivity,specificity and area under ROC curve(AUC)of smart pelvic floor ultrasound were 95.28%,64.76%and 0.827,respectively,which were significantly higher than those of MRI(89.72%,58.75%and 0.782)(all P<0.05).Conclusions Both transperineal smart pelvic ultrasound and MRI can more accurately assess the occurrence of postpartum SUI in PFD women,but the former has higher diagnostic value.

关 键 词：盆底疾病 产后期 超声检查 会阴 尿失禁 压力性 

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]