摘要
目的探讨经盆底超声检查评估膀胱膨出及Green分型在产后早期压力性尿失禁(SUI)诊断中的价值。方法选取127例经我院临床诊断为产后压力性尿失禁(PSUI)的产妇作为SUI组,另选取同期无SUI的产妇80例作为对照组,两组患者均接受盆底超声检查,测量静息状态下膀胱颈位置、膀胱尿道后角,最大Valsalva动作下的膀胱最低点位置、膀胱颈位置、膀胱尿道后角、肛提肌裂孔面积、尿道旋转角及膀胱颈移动度,观察尿道漏口有无开放。以临床诊断PSUI为金标准,采用受试者工作特征曲线(ROC)评估膀胱膨出及Green分型在产后早期SUI诊断中的价值。结果所有受试者前腔室解剖结构及膀胱膨出情况均能清晰观察,SUI组与对照组患者中膀胱膨出Green分型比较差异有统计学意义(P<0.01),应用盆底超声检查评估膀胱膨出及Green分型在产后早期SUI中,ROC曲线下面积(AUC)为0.805、敏感度、特异度、阳性预测值、阴性预测值分别为89.8%、71.2%、89.8%、71.3%,其中GreenⅡ型检出最多。结论经盆底超声检查能清晰显示前腔室解剖结构及其膀胱膨出情况,并对其做出分型诊断,对产后早期SUI的应用有推广价值。
Objective To investigate the value of transpelvic floor ultrasound and Green classification in the diagnosis of early postpartum stress incontinence.Methods 127 cases of postpartum stress urinary incontinence(SUI)clinically diagnosed in our hospital were selected as maternal SUI group,and 80 cases with no SUI were selected as a control group.Patients in both groups were accepted pelvic floor ultrasound.The resting state of the bladder neck,the maximum Valsalva action of bladder lowest position,bladder neck position,bladder urethra,anal ator hole area,urethral rotation Angle and bladder neck mobility were measured and the urethra leakage with open was observed.With clinical diagnosis of postpartum stress incontinence as the gold standard,the value of cystoele and Green classification in early postpartum period was evaluated.Results In all subjects,the value of cystoele Green classification in SUI and control patients was significantly different(P<0.01).Using pelvic floor ultrasound to evaluate cystoele and Green classification in early postnatal stress incontinence,area under the ROC curve(AUC)was 0.805.Sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were 89.8%,71.2%,89.8%,and 71.3%,respectively.The detection rate of GreenⅡtype was the highest.Conclusion Transpelvic floor ultrasound can clearly show the anatomical structure of the anterior chamber and cystoele,and promote the application of early postpartum SUI.
作者
孙凤兰
于婷芹
SUN Fenglan;YU Tingqin(Department of Special Inspection,Dezhou Maternal and Child Health Hospital,Dezhou 253000,China)
出处
《医学影像学杂志》
2023年第10期1853-1857,共5页
Journal of Medical Imaging
关键词
盆底超声检查
产后
压力性尿失禁
膀胱膨出
Pelvic floor ultrasound
Postpartum
Stress incontinence
Cystocele
