常规超声及前腔室结构参数对绝经期女性压力性尿失禁的诊断价值  

Clinical Value of Conventional Ultrasound and Anterior Chamber Structural Parameters in the Diagnosis of Stress Urinary Incontinence

作　　者：韩莉[1] 李金凤 HAN Li;LI Jinfeng(Obstetrics and Gynecology Department,Nanjing First Hospital,Nanjing,Jiangsu 210006,China;Functional Department,Nanjing First Hospital,Nanjing,Jiangsu 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)妇科,江苏南京210006 [2]南京医科大学附属南京医院(南京市第一医院)功能科,江苏南京210006

出　　处：《转化医学杂志》2024年第10期1564-1568,共5页Translational Medicine Journal

摘　　要：目的探究常规超声及前腔室结构参数诊断绝经期女性压力性尿失禁(SUI)的临床价值。方法回顾性选取2021年4月至2023年12月于南京医科大学附属南京医院(南京市第一医院)进行检查的绝经期女性80例,根据检查结果将其分为SUI组和非SUI组。所有受试者均采用超声于静息状态和最大Valsalva动作时进行检查,记录前腔室结构参数,并采用受试者工作特征(ROC)曲线分析前腔室结构参数对SUI的诊断价值。结果SUI组出现尿道内口漏斗率为58.82%,膀胱膨出率为73.53%,高于非SUI组(28.26%和30.43%)(P<0.05)。静息状态下,2组逼尿肌厚度(DWT)之间无显著差异(P>0.05),但SUI组静息状态下尿道倾斜角(UTA)和膀胱尿道后角(PUA)均大于非SUI组(P<0.05),膀胱颈位置(BNP)小于非SUI组(P<0.05)。最大Valsalva动作状态下SUI组尿道旋转角(URA)和膀胱颈移动度(BND)均大于非SUI组(P<0.05),膀胱颈至耻骨联合下缘水平垂直距离(BNS)小于非SUI组(P<0.05)。UTA、BNP、PUA、URA、BNS、BND对绝经期女性出现SUI的诊断曲线下面积(AUC)分别为0.717、0.619、0.607、0.799、0.704、0.773,其联合诊断的AUC(0.911)、敏感度(89.1%)、特异度(82.5%)较单独诊断效能更高。结论常规超声能够测量UTA、BNP、PUA、URA、BNS、BND等前腔室结构参数,将各参数联合进行绝经期女性SUI诊断,以提高诊断效能。Objective To explore the clinical value of conventional ultrasound and anterior chamber structural parameters in the diagnosis of stress urinary incontinence(SUI).Methods A retrospective study.Eighty postmenopausal women who underwent examination and treatment in our hospital from April 2021 to December 2023 were included.Based on their examination results,they were divided into the SUI group and non-SUI group.All women were examined using ultrasound at rest and during maximum Valsalva movement,recording the structural parameters of the anterior chamber,and analyzing the diagnostic value of these parameters for SUI using receiver operating characteristic(ROC)curves.Results According to routine ultrasound,58.82%of women in the SUI group had funnel formation at the internal urethral orifice and 73.53%had cystocele,which were higher than 28.26%and 30.43%in the non-SUI group(P<0.05).There was no significant difference in detrusor thickness(DWT)between the two groups(P>0.05).However,the resting urethral inclination angle(UTA)and PUA in the SUI group were higher than in the non-SUI group,and the BNP was lower than in the non-SUI group(P<0.05).Under the maximum Valsalva maneuver,the URA and BND in the SUI group were greater than those in the non-SUI group,while the BNS was lower than in the non-SUI group(P<0.05).The diagnostic AUC values for SUI using UTA,BNP,PUA,URA,BNS,and BND were 0.717,0.619,0.607,0.799,0.704,and 0.773,respectively.The combined diagnostic AUC was 0.911,with sensitivity and specificity of 89.1%and 82.5%,which were higher than individual diagnostic parameters.Conclusion Conventional ultrasound can measure anterior chamber structural parameters such as UTA,BNP,PUA,URA,BNS,and BND.Combining these parameters for SUI in Postmenopausal women diagnosis can improve diagnostic efficiency.

关 键 词：常规超声 压力性尿失禁 前腔室结构参数 绝经期 ROC曲线 

分 类 号：R694.54[医药卫生—泌尿科学] R695.1[医药卫生—外科学] R445.1[医药卫生—临床医学]