不同程度压力性尿失禁患者的盆底超声观察及危险因素分析
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摘要
目的探讨经会阴超声观察不同程度压力性尿失禁(Stress Urinary Incontinence,SUI)患者盆底结构的应用价值,并分析其危险因素,以期对临床干预进行指导。方法选取华北理工大学附属医院门诊就诊的SUI女性255例,分为轻度SUI组(111例)、中度SUI组(96例)、重度SUI组(48例),同期选择健康查体者266例为正常对照组。应用会阴超声动态观察上述研究对象的盆底结构,记录X_1、X_2,Y_1、Y_2,α_1、α_2,β_1、β_2,ΔDx、ΔDy, Mu,θ,对上述数据进行统计分析,并分析SUI的危险因素。结果正常对照组、轻度SUI组、中度SUI组、重度SUI组X_1、α_1、X_2、α_2、β_2、Mu、θ值依次增加,Y_1、Y_2依次减小,差异有统计学意义(P<0.05)。非条件Logistic回归分析显示年龄及体质指数(BMI)的增加是SUI发生、发展的独立危险因素。结论经会阴超声检查可以清晰显示不同程度SUI患者盆底结构的变化,年龄及BMI的增加是SUI发生、发展的独立危险因素。
Objective To investigate the value of the transperineal ultrasound in female with SUI indifferent degrees, and analyze its risk factors, in order to guide clinical intervention. Methods 255 patients with Stress Urinary Incontinence(SUI)(111 patients in the mild group, 96 in the moderate group, 48 in the severe one) and 266 control patients were included in our hospital. We applied the transperineal ultrasound observing their pelvic floor dynamically, recorded the ultrasonic parameters: X_1, X_2, Y_1, Y_2, α_1, α_2, β_1, β_2, ΔDx, ΔDy, θ, all of them were subjected to statistical analysis, at the same time the risk factors of SUI were analyzed. Results X_1, α_1, X_2, α_2, β_2, Mu and θ in turn increase in the control group, the mild SUI group, the moderate SUI group and the severe SUI group. but Y_1 and Y_2 in turn reduce(P<0.05); Logistic regression analysis results showed that the increase of age and BMI are independent risk factors for occurrence and development of SUI. Conclusion The transperineal ultrasonography clearly showed that the changes of pelvic floor structure in SUI patients with different degrees, the increase of age and BMI were shown to be independent risk factors for occurrence and development of SUI.
Objective To investigate the value of the transperineal ultrasound in female with SUI indifferent degrees, and analyze its risk factors, in order to guide clinical intervention. Methods 255 patients with Stress Urinary Incontinence(SUI)(111 patients in the mild group, 96 in the moderate group, 48 in the severe one) and 266 control patients were included in our hospital. We applied the transperineal ultrasound observing their pelvic floor dynamically, recorded the ultrasonic parameters: X_1, X_2, Y_1, Y_2, α_1, α_2, β_1, β_2, ΔDx, ΔDy, θ, all of them were subjected to statistical analysis, at the same time the risk factors of SUI were analyzed. Results X_1, α_1, X_2, α_2, β_2, Mu and θ in turn increase in the control group, the mild SUI group, the moderate SUI group and the severe SUI group. but Y_1 and Y_2 in turn reduce(P<0.05); Logistic regression analysis results showed that the increase of age and BMI are independent risk factors for occurrence and development of SUI. Conclusion The transperineal ultrasonography clearly showed that the changes of pelvic floor structure in SUI patients with different degrees, the increase of age and BMI were shown to be independent risk factors for occurrence and development of SUI.
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.
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[3] 肖汀,黄伟俊,曹韵清,等.超声观察膀胱膨出在女性压力性尿失禁诊断中的应用[J].中国超声医学杂志,2018,34(9):829-831.
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[6] 成平,王丹,吴雅菲,等.膀胱颈位置和移动度诊断女性产后轻度压力性尿失禁的价值[J].广西医学,2018,40(21):2552-2554.
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[8] 吴军,姜凡,张书杰,等.Valsalva动作下二维、三维超声与女性压力性尿失禁严重程度的相关性研究[J].安徽医科大学学报,2016,51(2):305-307.
[9] 白军,杨斌健,陈薇玲,等.压力性尿失禁病因学研究进展[J].中国妇产科临床杂志,2017,18(4):382-384.
[10] 李婕娜,李淑萍,陈玲,等.女性盆底功能障碍性疾病相关因素及盆底超声测定SUI的临床意义[J].中国妇幼保健,2014,29(14):2147-2149.
[11] GAMEIRO M O,SOUSA V O,GAMEIRO L F,et al.Comparison of pelvic floor muscle strength evaluations in nulliparous and primiparous women:a prospective study[J].Clinics (Sao Paulo),2011,66(8):1389-1394.
[2] 王丽华,陈军,邱月,等.经会阴超声对压力性尿失禁的诊断价值分析[J].中国超声医学杂志,2019,35(1):89-91.
[3] 肖汀,黄伟俊,曹韵清,等.超声观察膀胱膨出在女性压力性尿失禁诊断中的应用[J].中国超声医学杂志,2018,34(9):829-831.
[4] ABRAMS P,CARDOZO L,FALL M,et al.The standardisation of terminology in lower urinary tract function:report from the standardisat ion sub-committee of the International Continence Society [J] .Urology,2003,61(1) :37-49.
[5] 李红芹,吴大威,赵小明,等.女性压力性尿失禁患者疾病认知及就诊情况临床分析[J].中国妇幼保健,2015,30(11):1686-1687.
[6] 成平,王丹,吴雅菲,等.膀胱颈位置和移动度诊断女性产后轻度压力性尿失禁的价值[J].广西医学,2018,40(21):2552-2554.
[7] 李晓伟,王建六.尿失禁的病因和发病机制[J].实用妇产科杂志,2018,34(3):162-164.
[8] 吴军,姜凡,张书杰,等.Valsalva动作下二维、三维超声与女性压力性尿失禁严重程度的相关性研究[J].安徽医科大学学报,2016,51(2):305-307.
[9] 白军,杨斌健,陈薇玲,等.压力性尿失禁病因学研究进展[J].中国妇产科临床杂志,2017,18(4):382-384.
[10] 李婕娜,李淑萍,陈玲,等.女性盆底功能障碍性疾病相关因素及盆底超声测定SUI的临床意义[J].中国妇幼保健,2014,29(14):2147-2149.
[11] GAMEIRO M O,SOUSA V O,GAMEIRO L F,et al.Comparison of pelvic floor muscle strength evaluations in nulliparous and primiparous women:a prospective study[J].Clinics (Sao Paulo),2011,66(8):1389-1394.