女性膀胱脱垂亚型患者的二维超声声像图特征分析

Two-dimensional perineal ultrasound imaging features of female bladder prolapse subtypes

目的分析经会阴二维超声对女性膀胱脱垂亚型的声像图特征,为超声诊断女性膀胱脱垂提供参考。方法选择2013年7月至2016年6月海南省妇幼保健院收治的88例经盆腔器官脱垂定量评估系统进行检测初步确诊为阴道前壁膨出、膀胱脱垂的患者作为观察组,另选择88例健康体检者作为对照组。对所有入选者膀胱所处位置超声检查,并测定其膀胱尿道后角静息期和张力时期的倾斜角,分析声像图特征。结果在静息状态以及最大Valsalva动作时,观察组患者的尿道前角为(121.34±28.74)°,对照组为(123.62±13.71)°,差异无统计学意义(P>0.05),但是观察组患者的前角缩小率为(15.60±0.14)%、明显大于对照组的(9.02±0.07)%,差异有统计学意义(P<0.05);在静息状态以及最大Valsalva动作时,观察组患者和对照组的尿道后角分别为(113.25±12.01)°、(113.29±14.37)°,后角缩小率分别为(3.75±0.16)%、(3.81±0.26)%,差异均无统计学意义(P>0.05);静息状态下,观察组患者和对照组的的会阴长度分别为(5.40±2.03)cm、(5.39±2.51)cm,厚度分别为(7.11±1.36)mm和(6.82±1.29)mm,差异均有统计学意义(P>0.05);观察组患者中直肠膨出2例,膨出物深度为(16.15±5.24)mm,会阴运动过度10例,膨出物深度为(10.15±1.17)mm。结论经会阴二维超声技术可以获得膀胱脱垂亚型的超声特征,为临床诊断提供参考。

Objective To study the two-dimensional perineal ultrasound imaging features of female bladder prolapse subtypes. Methods From July 2013 to June 2016, 88 patients who were diagnosed as anterior vaginal wall prolapse or bladder prolapse by pelvic organ prolapse quantitative assessment system were selected as the observation group, and 88 healthy subjects were chosen as the control group. The position of the bladder of all the subjects was exam-ined by ultrasonography. The angle of the posterior urethral rest period and the tension period were measured, and the so-nographic features were analyzed. Results The anterior urethral angle at the resting state and the maximum Valsalva maneuver in the observation group was （121.34 ± 28.74）＆#176; , which was higher than （123.62 ± 13.71）＆#176; in the control group （P〉0.05）. However, the reduction rate of anterior urethral angle in the observation group was （15.60±0.14）%, which was significantly higher than （9.02 ± 0.07）%in the control group （P〈0.05）. The posterior urethral angles at the resting state and the maximum Valsalva maneuver in the observation group and the control group were respectively （113.25±12.01）＆#176; and （113.29 ± 14.37）＆#176;;the reduction rates of posterior urethral angle were respectively （3.75 ± 0.16）%and （3.81 ± 0.26）%（P〉0.05）. At the resting state, the perineal lengths of the observation group and the control group were respectively （5.40±2.03） cm and （5.39±2.51） cm;the perineal thickness were respectively （7.11±1.36） mm and （6.82±1.29） mm, and the differences were statistically significant （P〉0.05）. There were 2 cases of rectocele with the bulge depth of （16.15 ± 5.24） mm, and 10 cases of excessive perineal movement with the bulge depth of （10.15±1.17） mm. Conclusion The ul-trasound imaging features of bladder prolapse subtypes can be obtained by two-dimensional perineal ultrasound technol-ogy, and it can provide the reference for clinical diagnosis.