经会阴盆底超声检查在女性压力性尿失禁中的应用价值

Application value of transperineal pelvic floor ultrasonography in female stress urinary incontinence

目的研究经会阴盆底超声检查在女性压力性尿失禁(SUI)中的应用价值。方法选择2016年12月至2020年9月本院接收的167例SUI患者、100名健康体检女性,依次将其纳入观察组、对照组。根据分娩次数将观察组分为观察1组(80例,多次分娩)、观察2组(87例,初次分娩)。所有研究对象均进行经会阴盆底超声检查,比较各组的检查结果、膀胱尿道内口漏斗形成率。结果观察1组Valsalva动作时的膀胱颈下降度小于观察2组、对照组(P<0.05);观察1组尿道倾斜角、膀胱逼尿肌厚度、尿道膀胱后角、尿道旋转角、肛提肌裂孔面积、膀胱颈移动度均大于观察2组、对照组(P<0.05)。观察组重度患者的尿道倾斜角、膀胱逼尿肌厚度、尿道膀胱后角、尿道旋转角、肛提肌裂孔面积、膀胱颈移动度均大于中度,且中度大于轻度(P<0.05)。观察1组的膀胱尿道内口漏斗形成率高于观察2组(P<0.05)。结论经会阴盆底超声检查能够对多次分娩和妊娠SUI患者的尿道及膀胱颈周围支持结构进行观察,从而为临床制定盆底康复治疗方案提供参考,有助于提高SUI的治疗效果,临床应用价值较高。

Objective To study the application value of transperineal pelvic floor ultrasonography in female stress urinary incontinence(SUI).Methods A total of 167 SUI patients and 100 healthy women enrolled in our hospital from December 2016 to September 2020 were selected and included in observation group and control group in turn.The observation group was divided into observation group 1(80 cases,multiple delivery)and observation group 2(87 cases,initial delivery)according to the times of deliveries.All objects underwent transperineal pelvic floor ultrasonography,and the examination results and the formation rate of vesicourethral infundibulum of each group were compared.Results The descending degree of bladder neck during Valsalva action in the observation group 1 was less than that in the observation group 2 and the control group(P<0.05);the inclination angle of urethra,bladder detrusor thickness,posterior urethral bladder angle,urethral rotation angle,levator ani hiatus area and bladder neck movement of the observation group 1 were greater than those in the observation group 2 and the control group(P<0.05).The inclination angle of urethra,bladder detrusor thickness,posterior urethral bladder angle,urethral rotation angle,levator ani hiatus area and bladder neck movement of severe patients in the observation group were greater than those of moderate patients,and those of moderate patients was greater than the mild patients(P<0.05).The formation rate of vesicourethral infundibulum in the observation group 1 was higher than that in the observation group 2(P<0.05).Conclusion Transperineal pelvic floor ultrasonography can observe the supporting structures around the urethra and bladder neck of SUI patients with multiple delivery and pregnancy,which can provide reference for clinical formulation of pelvic floor rehabilitation treatment plan,help to improve the therapeutic effect of SUI,with higher clinical application value.