盆底超声在女性膀胱膨出与压力性尿失禁患者中的应用分析  

Application of Pelvic Floor Ultrasound in Women with Cystocele and Stress Urinary in Continence

作　　者：郭荣 李艳青[1] 张瑜 王小艳[1] 平卫伟 李静[1] GUO Rong;LI Yanqing;ZHANG Yu;WANG Xiaoyan;PING Weiwei;LI Jing(Department of Ultrasound,Heping Hospital affiliated to Changzhi Medical College)

机构地区：[1]长治医学院附属和平医院超声医学科,山西长治046000 [2]长治医学院公共卫生与预防医学系

出　　处：《长治医学院学报》2024年第3期209-212,224,共5页Journal of Changzhi Medical College

摘　　要：目的:探讨盆底超声对女性膀胱膨出分型与不同程度压力性尿失禁(SUI)的评估作用。方法:选择经盆底超声诊断为膀胱膨出的325名女性和100名健康女性为观察对象。100名健康女性为对照组,325名膀胱膨出女性依据有无SUI分为2组,无SUI纳入膨出组(n=160),有SUI纳入SUI组(n=165),并对SUI患者进行程度划分。每组均进行盆底超声,分别记录静息状态下膀胱尿道后角(PUA1)、最大Valsalva动作下膀胱后壁最低点下降值、膀胱颈移动度(BND)、尿道旋转角(UTA)、膀胱尿道后角(PUA2)、肛提肌裂孔面积(LHA)、尿道内口漏斗形成等指标,比较各组患者各项盆底参数的差异。结果:SUI组、膨出组中膀胱后壁最低点下降值、BND、UTA、PUA1及LHA均大于对照组,差异有统计学意义(P<0.05);SUI组PUA2大于对照组,膨出组PUA2小于对照组,差异均有统计学意义(P<0.05);SUI组中UTA、PUA2及LHA均大于膨出组,差异有统计学意义(P<0.05);SUI组中膀胱后壁最低点下降值小于膨出组,差异有统计学意义(P<0.05);SUI组与膨出组分别诊断Ⅰ型膀胱膨出56例、29例,Ⅱ型膀胱膨出79例、61例,Ⅲ型膀胱膨出30例、70例;其中GreenⅡ型SUI轻度37例、中度29例、重度13例,该分度中膀胱后壁最低点下降值、BND、UTA、PUA2、LHA水平依次增高,即轻度<中度<重度,差异有统计学意义(P<0.05)。结论:盆底超声能够准确评估膀胱膨出分型与SUI,分析出膀胱膨出分型与不同程度的SUI之间的相关性,并对不同程度的SUI进行实时可视化,为临床诊断及治疗提供精准的影像数据。Objective:To investigate the effectiveness of pelvic floor ultrasound in assessing female bladder prolapse classification and the severity of stress urinary incontinence(SUI).Methods:Three hundred and twenty-five women with bladder bulge diagnosed by pelvic floor ultrasound and 100 healthy women were the subjects of observation.100 healthy women were involved in the control group,and the 325 women with bladder bulge were divided into two groups according to the presence or absence of SUI.160 without SUI were included in the bulge group,and 165 with SUI were included in the SUI group which were divided into mild,moderate and severe.Each group underwent pelvic floor ultrasound examinations,including measurements of posterior urethrovesical angle during rest(PUA1),the lowest point of bladder posterior wall descent during the maximum Valsalva maneuver,bladder neck descent(BND),urethral rotation angle(UTA),posterior urethrovesical angle(PUA2),area of levator hiatus(LHA),and the formation of the internal urethral funnel.Statistical analysis were used to compare the pelvic floor parameters between the groups.Results:In the SUI group and the bulging group,the lowest point of descent of the posterior bladder wall,BND,UTA,PUA1 and LHA were greater than those in the control group,and the differences were statistically significant(P<0.05);in the SUI group,PUA2 was greater signficantly than that in the control group(P<0.05);in the bulging group,PUA2 was less than that in the control group,which the difference was statistically significant(P<0.05).In the SUI group,UTA,PUA2 and LHA were all significantly greater than those in the bulging group(P<0.05).UTA,PUA2 and LHA were greater than those in the expanded group(P<0.05),and the value of the nadir of the posterior wall of the bladder falling in the SUI group was smaller than that in the expanded group(P<0.05).Within the SUI group and the prolapse group,cases were diagnosed with TypeⅠprolapse in 56 and 29 instances,TypeⅡin 79 and 61 instances,and TypeⅢin 30 and 70 instance

关 键 词：盆底超声 膀胱膨出分型 压力性尿失禁 女性 

分 类 号：R445[医药卫生—影像医学与核医学]