实时三维超声结合高频超声对正常成年女性尿道长度与相关因素的影像学研究

Real Time Three Dimensional Ultrasound Combined With High Frequency Ultrasound Imaging In The Study Of The Length Of The Urethra And The Related Factors In Normal Adult Female

目的:探讨实时三维超声结合高频超声观察正常成年女性尿道长度与相关因素关系的研究。材料与方法:正常不同年龄组成年女性共150例,每组为30例,结合三维超声分别经腹部及经会阴部和高频超声经会阴观察女性尿道横断面及矢状面的超声声像图,测量女性尿道长度和观察尿道中段"支持平面"(即尿道-阴道间隔融合部)位置,分析不同年龄组、月经、性生活史、生育与尿道长度的关系。结果:1.高频超声对外阴、尿道外口及尿道远段显示好,对尿道中段和近段差,实时三维超声经腹部对尿道内口和尿道近段、中段显示好,对尿道远段差,实时三维超声经会阴部对尿道近段、中段、远段显示好,对尿道外口和会阴部差。2.绝经与否、有无性生活史、累计性生活史的时间、生育与否以及生育方式可影响尿道长度的变化。已绝经组小于未绝经组;累计性生活史时间长组大于累计性生活史时间短组及无性生活史组,累计性生活史时间短组与无性生活史组无明显区别;无生育史组小于生育史组,顺产史组小于剖腹产史组。3.年龄和女性尿道长度关系呈正偏态分布(即右偏态分布),峰值在30-40岁之间,之后随着年龄的增长,尿道长度整体呈下降趋势。4.女性尿道-阴道间隔融合部大部分位于中-远段连接部。结论:应用实时三维超声结合高频超声观察女性尿道,同时考虑绝经与否、有无性生活史、累计性生活史的时间、生育与否以及生育方式对尿道长度的影响,可以测量尿道长度及观察尿道中段"支持平面"(即尿道-阴道间隔融合部)的情况,能够为无张力尿道中段吊带术手术治疗SUI提供女性尿道长度个体化数据,为放置吊带的位置提供参考依据,具有重要的临床诊疗意义。

Purpose： To investigate the relationship between the length of the urethra and the related factors of the normal adult female with real-time three-dimensional ultrasound combined with high frequency ultrasound. Materials and Methods： Normal different age groups of adult women a total of 150 cases. Each group is 30 cases,combined with three-dimensional ultrasound respectively via abdomen and the pudendal and high-frequency ultrasound transperineal observation of female urethral axial and sagittal plane ultrasonographic and measurements of female urethral length and urethra were observed in the middle part of the support plane ＂（ i. e. urethra vaginal interval fusion） position,analysis the relationship between different age groups,menstruation,sexual life history,reproductive and urinary tract length. Results： 1. High frequency ultrasound of the vulva and urethral outside the mouth and the urethra distal display,difference of urethral middle and proximal,real-time three-dimensional ultrasound with abdomen of urethra and urethral mouth and proximal,middle shows good,of urethral far worse real-time three-dimensional ultrasound by the perineal urethra proximal,middle and distal segment of display,to the external urethral mouth and perineal difference. 2 menopause or not,there are asexual life history,the cumulative life history of the time,birth and not,as well as the way of birth can affect the change of urethral length. Postmenopausal group than in the premenopausal group; total life cycle time long group is greater than the cumulative history of sexual life time was shorter and asexual life history groups,the cumulative life cycle time was shorter and asexual life history group no obvious difference; without family history group was less than that of the family history group,eutocia history group less than laparotomy group. 3 age and female urethra length relationship was positively skewed distribution（ that is,the right skewed distribution）,the peak in the 40 to 30 years old,after the age of growth,the overall trend of urethral length decreased. 4 female urethra-vaginal septum of the majority of the Department is located in the middle and distal part of the junction. Conclusion： By real-time three-dimensional echocardiography combined with high frequency ultrasound observation of female urethral,taking menopause or not,sexual life history,cumulative effects of life history,birth and not and fertility of urethral length can measuring the length of the urethra and urethra were observed in the middle part of the support plane ＂（ i. e. urethra vaginal interval fusion）,to provide female urethral length of individual data for non tension Midurethral sling surgery treatment of Sui,provide reference for placing sling position,has important significance in clinical diagnosis and treatment.