盆底2D/4D超声在老年女性盆腔脏器脱垂诊断中的价值研究

Study on the Value of Pelvic Floor 2D/4D Ultrasound in the Diagnosis of Pelvic Organ Prolapse in Elderly Women

目的:探讨盆底2D/4D超声在老年女性盆腔脏器脱垂(POP)诊断中的应用价值。方法:选取2020年1—12月郑州市妇幼保健院确诊的64例老年女性POP患者作为研究组,另选取同期医院体检的64例健康老年女性作为健康对照组,均接受盆底2D/4D超声检查,比较两组受试者超声检查参数,分析各参数对老年女性POP的诊断价值。结果:研究组患者的膀胱颈移动长度(Mu)、尿道膀胱后角(Ar、As)、膀胱颈至耻骨联合中点间的距离值(Br、Bs)、膀胱颈旋转角度(θ)值均显著高于健康对照组,差异有统计学意义(t=8.309、4.855、5.053、6.449、6.364、6.524,P<0.05)。研究组患者静息状态、缩肛状态、Valsava运动时的肛提肌前后径、横径、面积均显著大于健康对照组,差异有统计学意义(t=3.632、 9.467、 22.657,P<0.05)。盆底2D超声对老年女性POP的诊断准确性为69.5%,特异性为73.4%,灵敏性为65.6%,阳性预测值为71.2%,阴性预测值为68.1%;盆底4D超声对老年女性POP的诊断准确性为78.1%,特异性为81.2%,灵敏性为75.0%,阳性预测值为80.0%,阴性预测值为76.5%。盆底2D/4D超声对老年女性POP的诊断准确性为94.5%,特异性为93.8%,灵敏性为95.3%,阳性预测值为93.8%,阴性预测值为95.2%。结论:盆底2D/4D超声可清晰显示老年女性POP患者的盆底结构,为老年女性POP诊断、手术方案确定及预后评估提供直观的影像学依据。

Objective:To investigate the value of pelvic floor 2D/4D ultrasound in the diagnosis of pelvic organ prolapse(POP) in elderly women.Methods:64 elderly female patients with POP diagnosed in hospitals from January 2020 to December 2020were selected as the study group,and another 64 healthy elderly women who were examined in hospitals during the same period were selected as the healthy control group.All the patients were examined by 2d/4d ultrasound at the bottom of the pelvis.All subjects underwent 2D/4D ultrasound examination of the pelvic floor.The ultrasound parameters of the two groups were compared,and the diagnostic value of each parameter for POP in elderly women was analyzed.Results:The values of bladder neck mobile length(Mu),urinary bladder posterior angle(Ar,As),distance values between the bladder neck and the midpoint of the pubic symphysis(Br,Bs),and bladder neck rotation angle(θ) were significantly higher in the study group than in the healthy control group,with statistically significant differences(t=8.309,4.855,5.053,6.449,6.364,6.524,P<0.05).The anterior-posterior diameter,transverse diameter,and area of the anal levator muscle were significantly greater in the study group than in the healthy control group in the resting state,the retracted state,and during Valsava exercise,with statistically significant differences(t=3.632,9.467,22.657,P<0.05).The diagnostic accuracy of 2D ultrasound of the pelvic floor in older women with POP was 69.5%,specificity was 73.4%,sensitivity was 65.6%,positive predictive value was 71.2%,and negative predictive value was 68.1%.The diagnostic accuracy of pelvic floor 4D ultrasound for POP in older women was 78.1%,specificity was 81.2%,sensitivity was 75.0%,positive predictive value was 80.0%,and negative predictive value was 76.5%.The diagnostic accuracy of pelvic floor 2D/4D ultrasound for POP in elderly women was 94.5%,specificity was 93.8%,sensitivity was 95.3%,positive predictive value was 93.8%,and negative predictive value was 95.2%.Conclusion:Pelvic floor 2D/4D ultrasound can clearly display the pelvic floor structure in elderly women with POP,providing a visual imaging basis for diagnosis,surgical plan determination and prognosis assessment of elderly women with POP.