超声评价膀胱颈漏斗形成在女性压力性尿失禁中的意义

发布时间：2018-01-26 04:04

本文关键词： 尿失禁压力性超声检查多普勒彩色膀胱尿道括约肌女(雌)性　出处：《中国医学影像学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨膀胱颈漏斗形成与盆底支持结构损伤及尿道括约肌缺陷之间的关联,及其在女性压力性尿失禁中的意义。资料与方法回顾性分析2015年4月-2016年8月于兰州大学第二医院门诊就诊的74例女性压力性尿失禁患者盆底图像。经会阴超声观察静息状态和最大Valsalva状态下膀胱颈位置、膀胱尿道后角及膀胱颈漏斗形成等,同时在静息状态下测量尿道中段括约肌厚度。同时纳入81例正常体检女性为对照组。结果最大Valsalva状态下,压力性尿失禁组中膀胱颈漏斗形成率(66.2%)明显高于对照组(4.9%),差异有统计学意义(P0.05);压力性尿失禁组的膀胱颈下降值及膀胱尿道后角明显大于对照组,差异均有统计学意义(P0.05);压力性尿失禁组经尿动力学证实9例存在尿道括约肌缺陷,均出现膀胱颈漏斗形成,其尿道中段括约肌厚度与无尿道括约肌缺陷及对照组对比,差异无统计学意义(P0.05)。结论膀胱颈漏斗形成是压力性尿失禁的重要指征,与盆底支持结构功能受损、尿道括约肌缺陷密切相关;但通过尿道括约肌厚度评估括约肌缺陷尚需进一步研究。
[Abstract]:Objective to investigate the relationship between bladder neck funnel formation and pelvic floor supporting structure injury and urethral sphincter defect. Data and methods the pelvic floor of 74 female patients with stress urinary incontinence from April 2015 to August 2016 in the outpatient clinic of the second Hospital of Lanzhou University were analyzed retrospectively. Image. The position of bladder neck in resting state and maximum Valsalva state was observed by transperineal ultrasound. The posterior horn of bladder urethra and bladder neck funnel were formed, and the thickness of sphincter of middle urethra was measured in resting state. 81 healthy women were included as control group. Results under the maximum Valsalva condition, the thickness of sphincter was measured. The rate of bladder neck funnel formation in the stress urinary incontinence group was significantly higher than that in the control group (P 0.05). The decrease of bladder neck and the posterior angle of bladder urethra in the stress urinary incontinence group were significantly higher than those in the control group (P 0.05). Urethral sphincter defect was found in 9 patients in the stress urinary incontinence group. The thickness of the middle urethral sphincter was compared with that in the control group. Conclusion the formation of bladder neck funnel is an important indication of stress urinary incontinence, which is closely related to the damage of pelvic floor supporting structure and the defect of urethral sphincter. However, the assessment of sphincter defect by the thickness of urethral sphincter needs further study.
【作者单位】：兰州大学第二医院超声科;
【基金】：兰州市科技计划项目(2016-2-71)
【分类号】：R445.1;R711.59
【正文快照】： 近年来,经会阴超声评估女性压力性尿失禁(stress约肌厚度;最大Valsalva状态下测量膀胱颈距耻骨联合urinary incontinence,SUI)盆底结构已成为一种诊断距离X2及膀胱尿道后角PUA2。同时计算膀胱颈下降SUI的新技术,并广泛应用于临床。既往研究表明,值(bladder neck descent,BND),

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