盆底超声下肛提肌裂孔面积、膀胱后壁距离、膀胱颈下降值与盆腔脏器脱垂女性POP-Q分期的关系探讨

The Relationship between Levator Ani Hiatus Area,Posterior Bladder Wall Distance,Decline Value of Bladder Neck Under Pelvic Floor Ultrasound and POP-Q Staging in Women with Pelvic Organ Prolapsed

目的探讨盆底超声下肛提肌裂孔面积、膀胱后壁距离、膀胱颈下降值与盆腔脏器脱垂(POP)女性盆腔脏器脱垂定量分期法(POP-Q)分期的关系。方法选取我院治疗的96例POP患者和同期体检无POP检查者30例进行研究,根据POP-Q分期结果将96例患者和30例检查者分为0期组(30例)、Ⅰ期组(31例)、Ⅱ期组(35例)、Ⅲ期/Ⅳ期组(30例),所有研究对象均进行盆底三维超声检查,比较各组患者的肛提肌裂孔面积、膀胱后壁距离、膀胱颈下降值,并进行多因素Logistic回归分析。结果不同分期的POP患者在静息状态和最大Valsalva动作下的肛提肌裂孔面积差异显著(P<0.05),随着POP-Q分期的增加,肛提肌裂孔面积呈上升趋势;不同分期的POP患者在最大Valsalva动作下的膀胱后壁距离和膀胱颈下降值差异显著(P<0.05),随着POP-Q分期的增加,膀胱后壁距离和膀胱颈下降值均呈上升趋势;多因素Logistic回归分析结果显示,肛提肌裂孔面积过大、膀胱后壁距离过大、膀胱颈下降值过大是导致患者POP-Q分期过高的独立危险因素。结论盆底超声下肛提肌裂孔面积、膀胱后壁距离、膀胱颈下降值与POP女性POP-Q分期具有较好的相关性。

Objective To explore the relationship between levator ani hiatus area,posterior bladder wall distance,decline value of bladder neck under pelvic floor ultrasound and staging of pelvic organ prolapse quantification(POP-Q)in women with pelvic organ prolapse(POP).Methods A total of 96 patients with POP treated in the hospital and 30 control people without POP were enrolled for this study.According to the results of POP-Q staging,they were divided into stage 0 group(30 cases),stageⅠgroup(31 cases),stageⅡgroup(35 cases),tageⅢ/Ⅳgroup(30 cases).All subjects were undergone three-dimensional pelvic floor ultrasound examination.The levator ani hiatus area,posterior bladder wall distance and decline value of bladder neck were compared among all groups.Multivariate Logistic regression analysis was conducted.Results There were significant differences in levator ani hiatus area among POP patients with different staging at rest status and under the maximum Valsalva maneuver(P<0.05).With the increase of POP-Q staging,levator ani hiatus area showed upward trends.There were significant differences in posterior bladder wall distance and decline value of bladder neck among POP patients with different staging under the maximum Valsalva maneuver(P<0.05).With the increase of POP-Q staging,posterior bladder wall distance and decline value of bladder neck showed upward trends.The results of multivariate Logistic regression analysis showed that too large levator ani hiatus area,too far posterior bladder wall distance and too large decline value of bladder neck were independent risk factors of too high POP-Q staging.Conclusion There is good correlation between levator ani hiatus area,posterior bladder wall distance,decline value of bladder neck under pelvic floor ultrasound and POP-Q staging in POP women.