盆底三维超声对压力性尿失禁女性膀胱颈移动度的研究

Characteristics of the bladder neck decent in women with stress urinary incontinence detected by transperineal three-dimensional ultrasonography

目的经会阴盆底三维超声动态观察压力性尿失禁女性膀胱颈移动度及盆膈裂孔面积的变化。方法选取2015-07~2017-12在陕西省人民医院门诊诊断为压力性尿失禁的女性90例(病例组),同期选取无症状健康女性60例(对照组)。根据测量静息状态及Valsalva动作后的膀胱颈位置,计算膀胱颈移动度,比较两组女性在静息状态和Valsalva动作后的膀胱颈移动度及相应盆膈裂孔面积变化。结果静息状态病例组与对照组膀胱颈位置分别为(2. 80±0. 50) cm与(2. 70±0. 60) cm,Valsalva动作后分别为(-1. 10±0. 90) cm与(1. 10±0. 50) cm,病例组与对照组膀胱颈移动度分别为(2. 90±1. 10) cm与(1. 70±0. 60) cm。静息状态两组膀胱颈位置比较差异无统计学意义(P> 0. 05),Valsalva动作后两组膀胱颈位置及膀胱颈移动度比较差异有统计学意义(P <0. 05)。静息状态病例组与对照组盆膈裂孔面积分别为(14. 80±1. 80) cm^2与(11. 70±2. 50) cm^2,Valsalva动作后分别为(20. 50±3. 10) cm^2与(15. 40±2. 20) cm^2,二者比较差异均有统计学意义(P <0. 05)。结论经会阴盆底超声动态检查显示,压力性尿失禁女性Valsalva动作后的膀胱颈位置明显降低、膀胱颈移动度增大,盆膈裂孔面积增大。

Objective To dynamic observation of the bladder neck decent（BND） and pelvic diaphragm hiatus in the diagnosis of female stress urinary incontinence（SUI） by transperineal three-dimensional ultrasonography. Methods From July 2015 to December 2017, 90 women with SUI were chosen as case group. In the mean time,60 healthy women were chosen as control group. The bladder neck positions were measured by ultrasound, at rest and on maximum Valsalva respectively. The BND and area of pelvic diaphragm hiatus were measured. Results The bladder neck position in case group and control group at rest was （2.80±0.50）cm/（2.70±0.60）cm, on maximum Valsalva was （-1.10±0.90）cm/（1.10±0.50）cm, respectively. The BND was （2.90±1.10）cm/（1.70±0.60）cm. There was no significant difference at rest in the two groups（P〉0.05）, and there was significantdifference on maximum Valsalva（P〈0.05）. The area of pelvic diaphragm hiatus in case group and control group at rest was （14.80±1.80 ）cm2/（11.70±2.50 ）cm2, on maximum Valsalva was （20.50±3.10）cm2/（15.40±2.20）cm2 , respectively. There were significantly increased than those in control group, at rest and on maximum Valsalva respectively （P〈0.05）.Conclusion Transperineal three-dimensional ultrasonography has great value for pelvic floor change in women with SUI, with enlargement of BND and area.