摘要
目的探讨压力性尿失禁(SUI)患者盆底三维超声参数变化的临床意义。方法前瞻性选取2018年1月至2020年4月湖南中医药高等专科学校附属第一医院收治的100例SUI患者作为观察组,另选取同期体检的无SUI等泌尿系统疾病的经产妇女100例作为对照组。比较两组、观察组不同病情程度患者、不同疗效患者静息状态、Valsalva动作盆底三维超声参数,分析盆底三维超声参数与SUI患者病情程度、疗效的关联性。结果⑴观察组静息状态下与Valsalva动作后膀胱尿道后角、Valsalva动作后盆膈裂孔面积大于对照组,静息状态下与Valsalva动作后耻骨直肠肌厚度小于对照组,差异有统计学意义(P<0.05);⑵静息状态下与Valsalva动作后膀胱尿道后角、Valsalva动作后盆膈裂孔面积、静息状态下与Valsalva动作后耻骨直肠肌厚度均与SUI有关(P<0.05);⑶不同病情程度比较:静息状态下与Valsalva动作后膀胱尿道后角、Valsalva动作后盆膈裂孔面积比较,轻度<中度<重度;静息状态下与Valsalva动作后耻骨直肠肌厚度比较,轻度>中度>重度;⑷治疗后,疗效不佳患者静息状态下与Valsalva动作后膀胱尿道后角、Valsalva动作后盆膈裂孔面积大于疗效良好患者,静息状态下与Valsalva动作后耻骨直肠肌厚度小于疗效良好患者,差异有统计学意义(P<0.05);⑸静息状态下与Valsalva动作后膀胱尿道后角、Valsalva动作后盆膈裂孔面积与病情程度、临床疗效呈正相关(P<0.05),静息状态下与Valsalva动作后耻骨直肠肌厚度与病情程度、临床疗效呈负相关(P<0.05)。结论盆底三维超声检查能有效反映不同动作状态下SUI患者盆底结构改变情况,为SUI病情程度判断、疗效评估提供重要解剖学及功能学依据。
Objective To explore the clinical significance of three-dimensional pelvic ultrasound parameters in patients with stress urinary incontinence(SUI).Methods A total of 100 patients with SUI in the First Hospital Affiliated to Hunan Traditional Chinese Medical College from January 2018 to April 2020 were prospectively selected as the observation group,and 100 women who had undergone birth without SUI and other urinary system diseases who came for physical examination during the same period were selected as the control group.Comparing the three-dimensional pelvic floor ultrasound parameters of resting state and Valsalva action in the patients with different degrees of illness,the patients with different efficacy of the two groups and the observation group.Analyzing the correlation between three-dimensional pelvic floor ultrasound parameters and the severity and efficacy of SUI patients.Results⑴The posterior urethrovesical angel at rest and after Valsalva action,the pelvic diaphragmatic hiatus area after Valsalva action in the observation group were larger than those in the control group,and the puborectalis muscle thickness at rest and after Valsalva action was smaller than that of the control group,with statistically significant difference(P<0.05);⑵The posterior urethrovesical angel at rest and after Valsalva action,the pelvic diaphragmatic hiatus area at rest,and the puborectalis muscle thickness at rest and after Valsalva action were related to SUI(P<0.05);⑶Comparison of patients with stress urinary incontinence of different severity:the posterior urethrovesical angel at rest and after Valsalva action,the pelvic diaphragmatic hiatus area after Valsalva action:mild<moderate<severe;the puborectalis muscle thickness at rest and after Valsalva action:mild>moderate>severe;⑷After treatment,the posterior urethrovesical angel and pelvic diaphragmatic hiatus area of patients with poor curative effect at rest and after Valsalva action were larger than those of patients with good curative effect,and the puborectalis muscle thickness of patients with poor curative effect at rest and after Valsalva action was smaller than that of patients with good curative effect,with statistically significant difference(P<0.05);⑸The posterior urethrovesical angel at rest and after Valsalva action,the pelvic diaphragmatic hiatus area after Valsalva action were positively correlated with the degree of disease and clinical efficacy,while the puborectalis muscle thickness was negatively correlated with the degree of disease and clinical efficacy at rest and after Valsalva action(P<0.05).Conclusions Three-dimensional pelvic floor ultrasound examination can effectively reflect the changes in pelvic floor structure of SUI patients under different action states,and provides important anatomical and functional basis for the judgment of SUI disease degree and the evaluation of curative effect.
作者
唐红艳
许厚本
刘玲
Tang Hongyan;Xu Houben;Liu Ling(Department of Functional,the First Hospital Affiliated to Advanced Academy of Traditional Chinese Medicine of Hunan Province,Zhuzhou 412000,China;Department of Gynecology,the First Hospital Affiliated to Academy of Traditional Chinese Medicine of Hunan Province,Zhuzhou 412000,China)
出处
《中国医师杂志》
CAS
2021年第6期868-873,共6页
Journal of Chinese Physician
基金
湖南省卫生计生委2015年度科研计划课题项目(B2015-77)。
关键词
尿失禁
压力性
成像
三维
骨盆底
超声检查
Urinary incontinence,stress
Imaging,three-dimensional
Pelvic floor
Ultrasonography
