经会阴超声诊断压力性尿失禁的价值分析

Evaluating the value of transperineal ultrasound in diagnosis of stress urinary incontinence in females

目的:探讨经会阴超声诊断女性压力性尿失禁(SUI)的临床应用价值。方法:选择2019年12月~2020年10月经临床诊断为SUI的患者56例为研究组,同期40例健康女性为对照组。两组均行经会阴二维超声检查,观察静息及最大Valsalva动作下有无尿道内口漏斗形成及膀胱膨出;测量静息及Valsalva动作下膀胱颈位置、尿道倾斜角、膀胱尿道后角,比较最大Valsalva动作下两组的超声参数。结果:最大Valsalva动作下,研究组膀胱颈移动度、尿道旋转角、膀胱尿道后角均大于对照组,差异有统计学意义(P<0.05);研究组膀胱膨出率及尿道漏斗形成率均高于对照组,差异有统计学意义(P<0.05)。结论:经会阴超声能够客观评估女性前盆腔解剖结构及其功能变化,多参数联合应用对临床诊断SUI及其手术前后的评估提供有效的影像学依据。

Objective:To evaluate the clinical application value of transperineal ultrasonography in women with stress urinary incontinence(SUI).Methods:Fifty-six women with SUI clinically confirmed were included from December 2019 to October 2020 in case group,and another 40 healthy females were recruited in the corresponding period as controls(control group).Women in the two groups underwent transperineal 2D ultrasound examination to observe the presence funnel formation and cystocele at the internal urethral orifice upon resting state and maximal Valsalva maneuver.The lowest point of bladder neck,urethral inclination angle and posterior vesicourethral angle of bladder were measured to compare the ultrasonic parameters at resting state and Valsalva maneuver of the two groups.Results:In the state of maximal Valsalva maneuver,the bladder neck movement,urethral rotation angle and bladder urethral posterior angle were greater in the case group than in the control group(P<0.05),and the rate of cystocele and urethral funnel formation were higher in case group than those in the control group(P<0.05).Conclusion:Transperineal ultrasonography can objectively demonstrate the anatomical structure and functional changes of anterior pelvic cavity in females,and the combined application of multiple parameters can provide quick and effective imaging evidence for the early diagnosis of SUI as well as the preoperative estimation of the severity and evaluation of postoperative efficacy.