三维超声检查在压力性尿失禁评估中的应用  

The application of three-dimensional ultrasound in the assessment of stress urinary incontinence

作　　者：张芬 杨晓[1] 李苗苗 郑晓蕾 ZHANG Fen;YANG Xiao;LI Miaomiao;ZHENG Xiaolei(Department of Ultrasound Medicine,Hefei Second People's Hospital,Hefei 230000,China)

机构地区：[1]安徽省合肥市第二人民医院超声医学科,安徽合肥230000

出　　处：《医学影像学杂志》2024年第12期139-142,146,共5页Journal of Medical Imaging

基　　金：安徽省自然科学基金项目(编号:2008085QH350);安徽省合肥市第二人民医院院级科研项目(编号:2021ygkt07)。

摘　　要：目的探讨三维超声检查在压力性尿失禁(SUI)诊断、严重程度评估中的应用效果,并分析其特点。方法选取107例女性SUI患者作为SUI组,另选同时期107例健康体检女性作为对照组,均行经会阴三维超声检查,比较SUI组与对照组、SUI组不同严重程度盆底超声检查参数,采用Logistics多因素回归分析三维超声检查参数与SUI的关系,采用Spearman等级相关系数分析三维超声检查参数与病情程度的相关性。结果SUI组静息状态与Valsalva状态下膀胱尿道后角(PUVA)、尿道角、膀胱角、中段尿道内径(Du)、膀胱颈到耻骨联合中点的距离(D0)及膀胱颈移动度(UVJ-M)均大于对照组,差异有统计学意义(P<0.05);SUI组轻度、中度、重度患者静息状态与Valsalva状态下尿道角、Du、D0及UVJ-M均依次增大,差异有统计学意义(P<0.05),重度患者静息状态下PUVA、膀胱角及Valsalva状态下膀胱角均大于轻度组,差异有统计学意义(P<0.05);Logistic多因素回归分析显示,静息状态下PUVA、Valsalva状态下PUVA、下尿道角、膀胱角、Du、D0静息状态下Du、UVJ-M均为SUI的独立相关因素(P<0.05);Spearman相关性分析显示,SUI患者静息状态和Valsalva状态下PUVA、下尿道角、Du,及Valsalva状态下膀胱角、D0、UVJ-M均与Selles分级呈正相关(P<0.05)。结论三维超声检查在SUI的诊断和严重程度评估中具有重要价值,部分三维超声检查参数是SUI的独立相关因素,且与SUI严重程度有显著相关性。Objective To explore the application effect of three-dimensional ultrasound in the diagnosis and severity evaluation of stress urinary incontinence(SUI)and to analyze its imaging characteristics.Methods 107 female SUI patients were selected and included in SUI group,and 107 healthy women with physical examination during the same period were enrolled as control group.Transperineal three-dimensional ultrasound was performed on all patients,and the pelvic floor ultrasound parameters were compared between SUI group and control group and among different severities in SUI group.The relationship between three-dimensional ultrasound parameters and SUI was analyzed by Logistics multivariate regression analysis,and the correlation between three-dimensional ultrasound parameters and disease severity was analyzed by Spearman rank correlation coefficient.Results The PUVA,urethral angle,bladder angle,Du and D0 in resting state and Valsalva state and UVJ-M in SUI group were higher than those in control group(P<0.05).Urethral angle,Du and D0 in resting state and Valsalva state and UVJ-M were increased successively in mild,moderate and severe patients in SUI group(P<0.05).The PUVA and bladder angle in resting state and bladder angle in Valsalva state of severe patients were greater than those of mild patients(P<0.05).Logistics multivariate regression analysis showed that PUVA in resting state,PUVA in Valsalva state,urethral angle in Valsalva state,bladder angle int Valsalva state,Du in resting state,Du in Valsalva state,D0 in Valsalva state and UVJ-M were independent-related factors for SUI(P<0.05).Spearman correlation analysis indicated that in patients with SUI,both resting and Valsalva maneuvers'PUVA,lower urethral angle,Du,as well as bladder angle,D0,and UVJ-M during Valsalva maneuvers,were positively correlated with the Selles grading system(P<0.05).Conclusion Transperineal three-dimensional ultrasound plays an important role in the diagnosis and severity evaluation of SUI.Some three-dimensional ultrasound parameters are ind

关 键 词：压力性尿失禁 超声检查 诊断 病程程度 

分 类 号：R711.77[医药卫生—妇产科学] R445.1[医药卫生—临床医学]