分析MVC、Valsalva状态下超声检查在压力性尿失禁评价中的应用价值

Analyze the application value of ultrasonography in the evaluation of stress urinary incontinence under maximum voluntary contraction and Valsalva states

目的探讨超声检查在最大自愿收缩(MVC)、Valsalva状态下对压力性尿失禁评价的应用价值。方法选取2020年1月至2023年1月于鄂尔多斯应用技术学院附属医院接受治疗的50例压力性尿失禁女性患者作为观察组,选取同期同医院接受体检的50例健康女性作为对照组。两组研究对象分别在MVC、Valsalva状态下行超声检查,比较两组盆底超声测量值(膀胱颈位置、肛提肌裂孔面积、膀胱尿道后角、尿道长度、尿道旋转角、膀胱移动度)以及尿道漏斗形成比例,同时采用尿垫试验结果来评估超声检查诊断压力性尿失禁的效能。结果两组基线资料比较差异无统计学意义(P>0.05);两组在MVC状态下行超声检查,观察组肛提肌裂孔面积、膀胱尿道后角均大于对照组;两组在Valsalva状态下行超声检查,观察组肛提肌裂孔面积、膀胱尿道后角均大于对照组;观察组尿道旋转角、膀胱移动度和尿道漏斗形成比例均大于对照组;超声诊断压力性尿失禁的灵敏度为96.00%(48/50),特异度为94.00%(47/50),阳性预测值为94.12%(48/51),阴性预测值为95.92%(47/49),诊断符合率为95.00%(95/100)。结论压力性尿失禁患者在MVC、Valsalva状态下行超声检查,可清晰、直观地显示盆底结构及功能,提供病情诊断依据,对患者的后续治疗有较高的临床价值。

Objective To explore the application value of ultrasonography in the evaluation of stress urinary incontinence under the states of maximum voluntary contraction(MVC)and Valsalva.Methods A total of 50 female patients with stress urinary incontinence who received treatment at the Affiliated Hospital of Ordos Institute of Applied Technology from January 2020 to January 2023 were selected as the observation group,and 50 healthy women who received physical examination in the same hospital during the same period were selected as the control group.Two groups of study subjects underwent ultrasonography under MVC and Valsalva states respectively.The two groups'pelvic floor ultrasound measurement values(bladder neck position,levator ani hole area,posterior horn of bladder and urethra,urethral length,urethral rotation angle,bladder mobility)and urethral funnel formation ratio were compared.At the same time,the results of urine pad test were used to evaluate the diagnostic efficiency of ultrasound examination for stress urinary incontinence.Results There was no difference in baseline data between the two groups(P>0.05).Ultrasound examination under MVC state showed that levator ani hole area,posterior horn of bladder in observation group were greater than those in control group.Ultrasound examination under Valsalva state showed that levator ani hole area,posterior horn of bladder in the observation group were all greater than those in the control group.The urethral rotation angle,bladder mobility and urethral funnel formation ratio in the observation group were greater than those in the control group.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic coincidence rate of stress urinary incontinence were 96.00%(48/50),94.00%(47/50),94.12%(48/51),95.92%(47/49)and 95.00%(95/100)respectively.Conclusions Ultrasonography of patients with stress urinary incontinence under MVC and Valsalva state can clearly and intuitively display the structure and function of pelvic floor,provide the diagnosis basis for disease condition,and have high clinical value for patients'follow-up treatment.