三维超声对压力性尿失禁妇女的盆底超声分析

Analyses of pelvic floor ultrasonography from in three-dimensional ultrasound in women with stress urinary incontinence

目的运用三维超声探究盆底超声检测在压力性尿失禁妇女中的应用。方法选取2015年5月～2017年3月在我院进行盆底超声检查的163例患者,按照是否确诊为压力性尿失禁疾病将其分为观察组和对照组,观察组为有明显压力性尿失禁症状,如腹压增加时尿液会不自主地流出的患者共78例,对照组为无压力性尿失禁的患者共85例,采用盆底超声测量比较两组患者的膀胱颈移动度(Mu)、尿道旋转角(θ)、Valsalva状态下膀胱尿道后角(αs、αr)等超声指标,并研究观察组中Mu、θ、αs、αr与疾病严重度是否有相关性及术前术后Mu、θ、αs、αr指标的变化。结果观察组患者的膀胱颈移动度Mu(1.79±0.24)cm、尿道旋转角θ(29.79±5.13)°和膀胱尿道后角αs(135.71±14.32)°、αr(120.04±11.27)°明显高于对照组的Mu(0.87±0.14)cm、θ(15.36±2.62)°、αs(103.82±8.94)°、αr(92.87±6.29)°,差异具有统计学意义(P<0.05);观察组治疗后的Mu(0.76±0.17)cm、θ(16.34±2.72)°、αs(98.65±9.56)°、αr(90.28±7.59)°超声指标明显低于治疗前的Mu(1.24±0.21)cm、θ(29.87±5.37)°、αs(135.13±14.02)°、αr(120.78±11.75)°,差异有统计学意义(P<0.05)。结论盆底超声检测膀胱颈移动度、尿道旋转角和膀胱尿道后角等指标对于诊断压力性尿失禁具有重要价值,并为患者术后治疗效果的检验提供理论依据。

Objective To explore the application of pelvic ultrasonography by three-dimensional ultrasonography in women with stress urinary incontinence. Methods 163 outpatient and inpatient patients, who were referred to our hospital for pelvic floor ultrasound examination from January 2015 to March 2017, were selected in this work. According to whether the stress urinary incontinence was diagnosed or not, those patients were divided into observation group and control group. In the observation group, there were 78 patients with abnormal urinary incontinence symptoms such as increased abdominal pressure and, whilst, in the control group, there were 85 patients who had no urinary incontinence. By means of pelvic floor ultrasonography, the bladder neck mobility （Mu）, urethral rotation angle （θ）, Valsalva state of bladder urethral angle （αs, αr） and other ultrasound indicators of patients in two groups were measured and whether the Mu, θ, αs, and were related to disease severity as well as preoperative and postoperative changes of those indexes of patients in the observation group were studied. Results The Mu （1.79 ± 0.24） cm, θ （29.79 ± 5.13） ° , αs （135.71 ± 14.32） °, and αr （120.04 ± 11.27） ° were significantly higher than those of （0.87 ± 0.14） cm, θ （15.36 ± 2.62） °, αs （103.82 ± 8.94） ° and αr （92.87 ± 6.29） ° in the control group, the difference was statistically significant （ P 〈0.05）. After treatment, Mu （0.16 ± 0.17） cm, θ （16.34 ± 2.72） °, αs （98.65 ± 9.56） ° and αr （90.28 ± 7.59） ° were significantly lower than those of Mu （1.24 ± 0.21） （29.87 ± 5.37） °, αs （135.13 ± 14.02） ° and αr （120.78 ± 11.75） ° in observation group, the difference was statistically significant （ P 〈0.05）. Conclusion Ultrasound detection of bladder neck movement, urethral rotation angle and bladder urethral posterior angle is of great value in the diagnosis of stress urinary incontinence and provides the theoretical basis for the treatment of postoperative treatment.