盆底超声在评估产后压力性尿失禁康复治疗的应用价值

Application Value of Pelvic Floor Ultrasound in Evaluating Rehabilitation Therapy of Postpartum Stress Urinary Incontinence

目的探讨盆底超声在评估产后压力性尿失禁(Stress Urinary Incontinence,SUI)康复治疗的应用价值。方法观察并记录60例产后6周SUI患者(观察组)行盆底超声检查时Valsala状态下的膀胱尿道后角、膀胱颈移动度量值、尿道内口漏斗是否形成,经盆底康复治疗并于产后12周复查盆底超声;另取60例无SUI经产妇女为对照组。结果产后6周观察组患者膀胱颈移动度、膀胱尿道后角明显增大,与对照组比较差异有统计学意义(P<0.05);产后12周观察组的膀胱颈移动度、膀胱尿道后角较产后6周明显减小,差异有统计学意义(t=2.535、2.579,P=0.017、0.014);尿道内口漏斗形成率明显减少,差异有统计学意义(χ~2=5.318,P=0.021)。结论盆底超声能直观有效地观察女性盆底结构,可用于产后盆底康复的评估。

Objective To investigate application value of pelvic floor ultrasound in evaluating rehabilitation therapy of postpartum stress urinary incontinence. Methods 60 women of postpartum stress urinary incontinence were selected to perform pelvic floor ultrasound in the first 6 weeks after delivery, investigated the situation of anterior pelvic, and recorded the posterior vesicourethral angle, bladder neck mobility and urethral mouth funnel formation rate in valsalva condition. They received pelvic floor rehabilitation therapy and reexamined with pelvic floor ultrasound 12 weeks after delivery. Other 60 parous women with no stress urinary incontinence were selected as control group. Results After 6 weeks postpartum, the bladder neck mobility and posterior vesicourethral angle in the observation group were significantly larger, which is statistically significant compared with those of control group（P〈0.05）. After 12 weeks postpartum, in observation group, the bladder neck mobility, posterior vesicourethral angle and urethral mouth funnel formation rates were significantly smaller than those of 6 weeks postpartum, and these differences have statistical significance（P〈0.05）（t value were 2.535 and 2.579 respectively, and P were 0.017 and 0.014 respectively）. The urethral mouth funnel formation rate dropped significantly, its difference is of statistical significance（χ~2=5.318, P=0.021）. Conclusion The pelvic floor ultrasound could clearly show the pelvic floor structure of women and can be used to evaluate the effect of postpartum pelvic floor rehabilitation therapy.