二维及三维超声诊断女性压力性尿失禁的临床价值

Clinical value of two-dimensional and three-dimensional ultrasonography in diagnosis of female stress urinary incontinence

目的探讨二维及三维超声检查诊断女性压力性尿失禁的临床价值。方法选取2015年8月-2016年12月在该院行超声检查并确诊为压力性尿失禁的女性患者80例(观察组);另选取同时间段来该院超声科检查的健康妇女80例(对照组)。两组患者均进行二维及三维超声盆底检查,记录并分析检查结果。结果观察组和对照组患者二维超声结果对比发现,观察组患者最大Valsalva动作后其膀胱颈明显移向后下方且移动度和对照组相比明显增大,两组数据比较差异具有统计学意义(P<0.05);观察组患者在静息状态以及最大Valsalva动作后膀胱尿道后角较对照组患者明显增大,两组数据同样具有统计学意义(P<0.05);观察组患者在最大Valsalva动作状态下与对照组相比尿道旋转度明显增加(P<0.05);余测量数据(如静息状态下尿道长度以及尿道倾斜角等)比较,差异无统计学意义(P>0.05)。通过三维超声对两组患者进行检查发现,耻骨直肠肌以及盆膈裂孔显示清晰,在最大Valsalva状态下和对照组相比,观察组患者耻骨直肠肌厚度更小,而盆膈裂孔面积则更大,两组数据比较差异有统计学意义(P<0.05)。结论女性压力性尿失禁患者伴有不同程度的膀胱颈和尿道支持结构改变,通过二维以及三维超声能够清晰显示,为临床确诊提供参考依据。

Objective To explore the clinical value of two-dimensional and three-dimensional ultrasonography in diagnosis of female stress urinary incontinence（SUI）.Methods Eighty female patients diagnosed as SUI by ultrasonography in People＇s Hospital of Yongchuan District from August 2015 to December 2016 were selected as observation group,and eighty healthy women receiving ultrasonography in the hospital during the same period were selected as control group.Two-dimensional and three-dimensional pelvic ultrasonography were performed in the two groups,the results were recorded and analyzed.Results Comparison of results of two-dimensional pelvic ultrasonography between the two groups：bladder neck moved to rear and below side after the maximum Valsalva manoeuvre in observation group,the degree was statistically significantly larger than that in control group（P 0.05）.Poster urethrovesical angel in a resting state and after the maximum Valsalva manoeuvre in observation group were statistically significantly larger than those in control group（P0.05）.Urethral rotation degree after the maximum Valsalva manoeuvre in observation group was statistically significantly larger than that in control group（P0.05）.There was no statistically significant difference in the other data between the two groups（P0.05）.Three-dimensional pelvic ultrasonography found that musculi puporectalis and hiatus of diaphragma pelvis were displayed clearly,compared with control group,the thickness of musculi puporectalis after the maximum Valsalva manoeuvre in observation group was thinner than that in control group,while the area of hiatus of diaphragma pelvis in observation group was larger,there were statistically significant differences between the two groups（P0.05）.Conclusion The female patients with SUI often complicate with structural changes of cervix vesicae and urethral support structure in varying degrees,which can be displayed clearly by two-dimensional and three-dimensional ultrasonography,and it provides reference basis for definite diagnosis.