经会阴超声对压力性尿失禁的诊断价值分析
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摘要
目的探讨经会阴超声对压力性尿失禁(SUI)的诊断价值。方法选取39例SUI女性及39例健康女性作为病例组及对照组。两组均行经会阴超声检查,观察静息和最大Valsalva状态下有无膀胱膨出、尿道内口漏斗形成,测量膀胱颈位置(x,y)及其移动度(△x、△y)、膀胱尿道后角(α)、尿道倾斜角(β)、尿道旋转角(△β),分析各指标在SUI中的诊断价值。结果 (1)静息状态下,两组对比膀胱膨出、漏斗形成、rx、ry、αr、βr等指标,差异无统计学意义。(2)Valsalva状态下,两组对比膀胱膨出、漏斗形成、△y、αv、βv、△β等指标,差异有统计学意义(P<0.05);应用ROC曲线分析,以上指标曲线下面积均>0.7,灵敏度及特异度较高,对SUI诊断有较高价值。结论盆底超声能够清晰观察盆底结构及其动态变化,应用多参数指标可以对SUI诊断及术前术后评估提供影像学依据,值得临床推广。
Objective To explore the diagnostic value of transvaginal ultrasonography in stress urinary incontinence(SUI).Methods 39 SUI women and 39 healthy women were selected as the case group and the control group.Both groups through perineum ultrasound examination,observation of resting and maximum Valsalva of the bulging state of bladder,urethral mouth funnel form,measurement of the location of the bladder neck(x,y)and the degree of excursion(△x,△y),posterior vesicourethral angle(α),angle of inclination of urethra(β),urethral rotation angle(△β),analysis of diagnostic value of each index in the SUI.Results (1) In the state of rest,the two groups compared the indexes of bladder bulge,funnel formation,rx,ry,αr,βr,without statistical significance.(2) In the state of Valsalva,the two groups compared the indexes of bladder bulge,funnel formation,△y,αv,βv,△β,with statistical significance(P<0.05).By using ROC curve analysis,the area under the curve of the above indexes is all greater than 0.7,with high sensitivity and specificity,which is of high value for the diagnosis of SUI.Conclusions Pelvic floor ultrasound can clearly observe the pelvic floor structure and its dynamic changes,and the application of multi-parameter indicators can provide imaging basis for the diagnosis of SUI and the evaluation of preoperative and postoperative treatment,which is worthy of clinical promotion.
Objective To explore the diagnostic value of transvaginal ultrasonography in stress urinary incontinence(SUI).Methods 39 SUI women and 39 healthy women were selected as the case group and the control group.Both groups through perineum ultrasound examination,observation of resting and maximum Valsalva of the bulging state of bladder,urethral mouth funnel form,measurement of the location of the bladder neck(x,y)and the degree of excursion(△x,△y),posterior vesicourethral angle(α),angle of inclination of urethra(β),urethral rotation angle(△β),analysis of diagnostic value of each index in the SUI.Results (1) In the state of rest,the two groups compared the indexes of bladder bulge,funnel formation,rx,ry,αr,βr,without statistical significance.(2) In the state of Valsalva,the two groups compared the indexes of bladder bulge,funnel formation,△y,αv,βv,△β,with statistical significance(P<0.05).By using ROC curve analysis,the area under the curve of the above indexes is all greater than 0.7,with high sensitivity and specificity,which is of high value for the diagnosis of SUI.Conclusions Pelvic floor ultrasound can clearly observe the pelvic floor structure and its dynamic changes,and the application of multi-parameter indicators can provide imaging basis for the diagnosis of SUI and the evaluation of preoperative and postoperative treatment,which is worthy of clinical promotion.
引文
[1]李志毅,朱兰.女性压力性尿失禁流行病学现状[J].实用妇产科杂志,2018,34(3)161-162.
[2] DIETZ H P,KAMISAN A,SALITA A.Association between ICS POP-Q coordinates and translabial ultrasound findings:implications for the definition of normal pelvic organ support[J].Ultrasound Obstet Gynecol,2016,47(3):363-368.
[3]朱兰,郎景和.女性盆底学[M].北京:人民卫生出版社,2014:55.
[4]徐静,张新玲,毛永江,等.尿道内口漏斗形成对女性压力性尿失禁患者的诊断价值[J].中国超声医学杂志,2016,32(3):252-255.
[5]黄淑卿,张新玲,郑志娟,等.盆底超声在产后早期压力性尿失禁中的应用[J].中国超声医学杂志,2015,31(5):433-435.
[6] SHEK K L,DIETZ H P.Minerva ginecol[J].Pelvic floor ultrasonography:an update,2013,65(1):1-20.
[2] DIETZ H P,KAMISAN A,SALITA A.Association between ICS POP-Q coordinates and translabial ultrasound findings:implications for the definition of normal pelvic organ support[J].Ultrasound Obstet Gynecol,2016,47(3):363-368.
[3]朱兰,郎景和.女性盆底学[M].北京:人民卫生出版社,2014:55.
[4]徐静,张新玲,毛永江,等.尿道内口漏斗形成对女性压力性尿失禁患者的诊断价值[J].中国超声医学杂志,2016,32(3):252-255.
[5]黄淑卿,张新玲,郑志娟,等.盆底超声在产后早期压力性尿失禁中的应用[J].中国超声医学杂志,2015,31(5):433-435.
[6] SHEK K L,DIETZ H P.Minerva ginecol[J].Pelvic floor ultrasonography:an update,2013,65(1):1-20.