盆底超声参数及孕产妇临床因素与产后压力性尿失禁的相关性  

The correlation between pelvic floor ultrasound parameters,clinical factors of pregnant women,and postpartum stress urinary incontinence

作　　者：郑志燕 徐伟[2] 唐文成 储玲玲 葛环 常小霞 ZHENG Zhiyan;XU Wei;TANG Wencheng;CHU Lingling;GE Huan;CHANG Xiaoxia(aUltrasound Department,Chuzhou First People's Hospital,Chuzhou,Anhui 239000,China;Imaging Department,Anhui Medical University Affiliated Chuzhou Hospital,Chuzhou First People's Hospital,Chuzhou,Anhui 239000,China;Women's Health Department,The First Affiliated Hospital of Nanjing Medical University,Jiangsu Provincial People's Hospital,Jiangsu Maternal and Child Health Hospital,Nanjing,Jiangsu 210036,China)

机构地区：[1]安徽医科大学附属滁州医院、滁州市第一人民医院超声科,安徽滁州239000 [2]安徽医科大学附属滁州医院、滁州市第一人民医院影像科,安徽滁州239000 [3]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,江苏南京210036

出　　处：《安徽医药》2025年第4期716-720,共5页Anhui Medical and Pharmaceutical Journal

基　　金：中华预防医学会科研资金支持项目(201810033)。

摘　　要：目的探索盆底三维超声参数、孕产妇临床因素与产后早期压力性尿失禁的相关性。方法选取2022年3月至2023年6月于滁州市第一人民医院进行产后42 d盆底三维超声检查的170例病人,均有完整的产前产时资料,其中,有压力性尿失禁症状的76例作为研究组,无压力性尿失禁症状的94例作为对照组,比较两组女性盆底超声参数和临床因素的不同,探索盆底超声参数、临床因素与产后早期压力性尿失禁的相关性。结果两组产后女性在受教育程度、孕中晚期盆底肌训练、产前身体质量指数(BMI)[27.00(25.59,28.12)kg/m^(2)比29.15(27.73,32.00)kg/m^(2)]比较,差异有统计学意义(P<0.05);在膀胱颈移动度[(16.34±7.37)mm比(28.87±6.21)mm]、尿道旋转角[(36.79±14.18)°比(53.01±9.89)°]、膀胱尿道后角[(124.72±21.50)°比(145.34±15.46)°]、肛提肌裂孔面积[(26.24±4.52)cm^(2)比(30.76±3.34)cm^(2)]比较,差异有统计学意义(P<0.05);通过Spearman相关分析,孕中晚期盆底肌训练与尿失禁影响问卷评分(ICI-Q-SF)存在负相关性(r=−0.26,P<0.05),产前BMI、膀胱颈移动度、尿道旋转角、膀胱尿道后角与ICI-Q-SF存在正相关性(r=0.72,P<0.001;r=0.45,P<0.001;r=0.64,P<0.001;r=0.30,P<0.05)。结论膀胱颈移动度、尿道旋转角、膀胱尿道后角与产后早期SUI有一定的相关性,结合孕产妇临床因素,可指导临床制定合理的干预策略,评估预后,提高女性生活质量。Objective To explore the correlation between pelvic floor three-dimensional ultrasound parameters,clinical factors of pregnant women,and early postpartum stress urinary incontinence.Methods A total of 170 patients who underwent 42 day postpartum pelvic floor three-dimensional ultrasound examination at Chuzhou First People's Hospital from March 2022 to June 2023 were selected,all of whom had complete prenatal data.Among them,76 patients with stress urinary incontinence symptoms were selected as the study group,and 94 patients without stress urinary incontinence symptoms were selected as the control group.The differences in pelvic floor ultrasound parameters and clinical factors between the two groups of women were compared to explore the correlation between pelvic floor ultrasound parameters,clinical factors,and early postpartum stress urinary incontinence;the difference was statistically significant(P<0.05).Results There was a statistical difference between the two groups of postpartum women in terms of education level,pelvic floor muscle training in the middle and late stages of pregnancy,and prenatal BMI[27.00(25.59,28.12)kg/m²vs.29.15(27.73,32.00)kg/m²](P<0.05);there was a statistical difference in the mobility of the bladder neck[(16.34±7.37)mm vs.(28.87±6.21)mm],urethral rotation angle[(36.79±14.18)°vs.(53.01±9.89)°],posterior angle of the bladder urethra[(124.72±21.50)°vs.(145.34±15.46)°],and area of the levator ani muscle hiatus[(26.24±4.52)cm²vs.(30.76±3.34)cm²](P<0.05);through Spearman correlation anal-ysis,there was a negative correlation between pelvic floor muscle training and ICI-Q-SF in the middle and late stages of pregnancy(r=-0.26,P<0.05),while there was a positive correlation between prenatal BMI,bladder neck mobility,urethral rotation angle,and bladder urethral posterior angle and ICI-Q-SF(r=0.72,P<0.001;r=0.45,P<0.001;r=0.64,P<0.001;r=0.30,P<0.05).Conclusions There is a certain correlation between bladder neck mobility,urethral rotation angle,and bladder urethral posterior angl

关 键 词：尿失禁 压力性 盆底超声 产妇 盆底肌训练 膀胱颈移动度 盆底功能障碍 

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]