经会阴二维超声在女性压力性尿失禁中的临床应用

Clinical application of female stress urinary incontinence with transperineal two-dimensional ultrasound

目的探讨经会阴二维超声在女性压力性尿失禁(FSUI)的诊断、临床分型及病因鉴定中的临床应用价值。方法对77例FSUI患者(病例组)和41名健康体检女性(对照组)行经会阴二维超声,观察静息和瓦氏动作后膀胱颈、膀胱后角及近端尿道的动态变化、静息时膀胱颈有无漏斗形成、是否合并膀胱膨出及子宫脱垂情况,并进行比较分析。结果病例组静息和瓦氏动作后膀胱颈y轴位移(Δy)、静息时膀胱后角(α)、瓦氏动作后膀胱后角及近端尿道旋转度大于对照组(P均<0.05);病例组静息时膀胱颈漏斗形成率、合并膀胱膨出率及子宫脱垂率大于对照组(P<0.05);病例组静息至瓦氏动作后膀胱颈x轴位移略大于对照组,但差异无统计学意义(P>0.05)。结论经会阴二维超声可实时动态显示盆底组织结构,可对FSUI的临床分型及病因鉴定提供丰富的影像学信息,在FSUI的诊断、治疗及预后判断方面均有具重要意义。

Objective To evaluate the clinical application value in diagnosis,clinical classification and etiology identification of female stress urinary incontinence（FSUI）with transperineal two-dimensional ultrasound.Methods Perineal twodimensional ultrasound were performed in 77 women with FSUI（case group）and 41 healthy women without FSUI（control group）at the moment of resting state and Valsalva maneuver.Dynamic changes of the bladder neck,posterior angle of the bladder and proximal urethra were observed.The bladder neck with or whitout funnel was evaluated in resting state.Whether there were associated cystocele and descensus uteri was also observed.Results The yaxis moving distance（Δy）of the bladder neck from resting state to Valsalva maneuver,posterior angle of the bladder in resting state,posterior angle of the bladder after Valsalva maneuver and rotation degree of the proximal urethra of case group were higher than those of the control group（all P〈0.05）.Funnel formation rate of the bladder neck,cystocele rate and descensus uteri rate of case group were higher than those of the control group（all P〈0.05）.The xaxis moving distance from resting state to Valsalva maneuver of case group was greater than that of the control group,but there was no significant statistical difference（P〉0.05）.Conclusion Transperineal two-dimensional ultrasound can display pelvic floor tissue real-time and dynamically,providing experienced imaging information for clinical classification and etiology of FSUI.It has important significance in diagnosis,treatment and prognosis of FSUI.