缩肛状态下肛提肌应变率用于评价压力性尿失禁患者盆底肌收缩功能的价值

发布时间：2018-11-24 10:40

【摘要】：目的研究缩肛状态下肛提肌应变率评价压力性尿失禁患者盆底肌收缩功能中的价值,从而为临床提供可量化的客观指标。方法选取77例压力性尿失禁患者作为研究对象,根据Oxford肌力分级标准分为肌力障碍组27例和非肌力障碍组50例;选择30例其他普通妇科疾病且无盆底肌功能障碍患者作为健康对照组。比较3组缩肛状态下的肛提肌应变率;分析缩肛状态下肛提肌应变率与Oxford肌力分级的相关性;并通过绘制受试者工作特征曲线来探索缩肛状态下肛提肌应变率诊断盆底肌收缩功能障碍的最佳临界值。结果肌力障碍组缩肛状态下肛提肌应变率低于其他两组(P0.05)。Oxford肌力分级与缩肛状态下肛提肌应变率呈正相关(r=0.815,P0.05)。缩肛状态下肛提肌应变率诊断盆底肌收缩功能障碍最佳临界值为10.07%,曲线下面积为0.888(P0.05),其灵敏度、特异度、阳性预测值及阴性预测值分别为91.8%、78.6%、80.8%、86.3%。结论缩肛状态下肛提肌应变率对压力性尿失禁患者盆底肌收缩功能障碍的诊断具有一定价值,但仍需进一步研究以证实其对其他类型疾病患者盆底肌功能的诊断效能。
[Abstract]:Objective to study the value of the strain rate of levator ani muscle in evaluating the pelvic floor muscle contraction function in patients with stress urinary incontinence, and to provide an objective and quantifiable index for clinical practice. Methods Seventy-seven patients with stress urinary incontinence were divided into two groups according to Oxford criteria: 27 patients with dyskinesia and 50 patients with non-dyskinesia. Thirty patients with other gynecological diseases without pelvic floor dysfunction were selected as healthy control group. The strain rate of levator ani muscle was compared in three groups, and the correlation between the strain rate of levator ani muscle and the grading of Oxford muscle strength was analyzed. The optimal critical value of strain rate for the diagnosis of pelvic floor muscle contraction dysfunction was explored by drawing the operating characteristic curve of the subjects. Results the strain rate of levator ani muscle in the dystonia group was lower than that in the other two groups (P0.05). There was a positive correlation between the strain rate of levator ani muscle and the strain rate of levator ani muscle in the anus contraction state (P 0.05). The best critical value of strain rate for the diagnosis of pelvic floor muscle contraction dysfunction was 10.07 and the area under the curve was 0.888 (P0.05). Its sensitivity, specificity, positive predictive value and negative predictive value were 91.8, respectively. Seventy-eight is about 86.3. Conclusion the strain rate of levator ani muscle under anus contraction is valuable for the diagnosis of pelvic floor muscle contraction dysfunction in patients with stress urinary incontinence, but it still needs further study to confirm its diagnostic effect on pelvic floor muscle function in patients with other types of diseases.
【作者单位】：湖北医药学院附属东风医院超声科;
【基金】：湖北省教育厅科研项目(B2014064)
【分类号】：R445.1;R711.59

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