多模态超声参数诊断产后早期压力性尿失禁价值  

Predictive value of the multimodal ultrasound parameters of women for their early postpartum stress urinary incontinence

作　　者：闵欢 刘家开 张竞 严晓燕 吴垠 周春美 MIN Huan;LIU Jiakai;ZHANG Jing;YAN Xiaoyan;WU Yin;ZHOU Chunmei(The Second Affiliated Hospital of Chengdu Medical College(China National Nuclear Corporation 416 Hospital),Chengdu,Sichuan Province,610000)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院,610000

出　　处：《中国计划生育学杂志》2025年第3期727-731,共5页Chinese Journal of Family Planning

基　　金：2023年度成都医学院科学研究机开放课题和临床科学研究基金项目(23LHHGYSD36)。

摘　　要：目的:探究多模态超声参数对产后早期压力性尿失禁(SUI)的诊断价值。方法:选取2021年7月-2023年6月本院就诊的106例足月单胎阴道分娩后6~8周产妇为观察组,根据是否确诊为SUI分为SUI组(n=49)和非SUI组(n=57),体检健康女性80例为对照组;入组对象均接受身体检查、排尿动力检查及二维、三维盆底超声,对比观察组与对照组、SUI组与非SUI组多模态超声参数,分析多模态超声参数与SUI的关系及对SUI的预测价值。结果:106例单胎足月阴道分娩产妇中发生SUI49例,SUI发生率为46.2%。与对照组比,观察组肛提肌裂孔面积(LHA2)、膀胱颈位置(H1BL、H2BL)及ΔHBL均高于对照组(均P<0.05),两组LHA1、膀胱尿道后角(PUVA1、PVUA2)、尿道旋转角度(URA)、尿道倾斜角(UIA1、UIA2)比较无差异(P>0.05);SUI组LHA1、LHA2、PVUA1、PVUA2、URA、UIA2、H1BL、H2BL及ΔHBL均高于非SUI组(均P<0.05),两组UIA1比较无差异(P>0.05)。logistic回归分析显示,LHA1、H2BL与SUI有关,可能是其发生的风险因子(OR=0.392、0.031,P<0.05)。ROC曲线分析显示,LHA1、H2BL诊断产后SUI具有一定价值,曲线下面积(AUC)均>0.70,截断值分别为17.64cm、-0.73cm时,2项联合时(AUC=0.962)诊断价值最佳。结论:多模态超声参数可较好的评估足月单胎阴道分娩产妇产后早期盆底结构与功能变化,LHA1、H2BL联合检测对产后早期SUI有一定较高诊断价值。Objective:To explore the predictive value of the multimodal ultrasound parameters of women for their early postpartum stress urinary incontinence(SUI).Methods:106 full-term singleton women during 6-8 weeks after vaginal delivery who had admitted to the hospital from July 2021 to June 2023 were selected in observation group.According to whether the women were diagnosed with SUI,these women were divided into group A(49 cases with SUI)and group B(57 cases without SUI).In addition,80 healthy women who received physical examination were included in control group during the same period.All the enrolled women received the physical examination,the urodynamic examination,and the two-dimensional and three-dimensional pelvic floor ultrasound.The multimodal ultrasound parameters values of the women were compared between the observation group and the control group and between group A and group B.The correlation between the multimodal ultrasound parameters values of the women and their SUI occurrence and the predictive values of the multimodal ultrasound parameters of the women for their SUI occurrence were analyzed,Results:There were 49(46.2%)cases with the SUI occurred in 106 singleton full-term women with vaginal delivery.The values of the levator hiatus area(LHA2),bladder neck position(H1BL,H2BL)and△HBL of the women in the observation group were significantly higher than those of the women in the control group(all P<0.05).There were no significant differences in the values of LHAl,PUVAl,PVUA2,urethral rotation angle(URA)and urethral tilt angle(UIA1,UIA2)of the women between the observation group and the control group(P>0.05).The values of LHA1,LHA2,PVUA1,PVUA2,URA,UIA2,H1BL,H2BL and△HBL of the women in group A were significantly higher than those of the women in group B(all P<0.05),and there was no significant difference in the UIA1 values of the women between group A and group B(P>0.05).Logistic regression analysis showed that the LHAl and H2BL values of the women were related to their SUI occurrence,and which may be

关 键 词：阴道分娩 产后压力性尿失禁 多模态超声 盆底超声 预测价值 

分 类 号：R71[医药卫生—妇产科学]