经会阴实时三维超声在女性压力性尿失禁患者中的应用

发布时间：2018-02-16 14:10

本文关键词： 三维超声压力性尿失禁价值吊带　出处：《广东医学》2017年18期 　论文类型：期刊论文

【摘要】：目的探讨经会阴实时三维超声在女性压力性尿失禁(SUI)患者手术前评估及术后疗效评估中的临床应用价值。方法收集SUI患者32例(SUI组),同时选取32例年龄匹配的健康女性为对照组,对照组及SUI组术前及术后3个月均行经会阴实时三维超声检查,比较两组在不同状态下(静息、Valsalva动作)膀胱颈位置、尿道、盆膈裂孔、耻骨内脏肌形态等参数,同时比较经阴道尿道中段无张力悬吊手术(TVT-O)手术前后患者膀胱颈、尿道等解剖结构的变化,以及术后吊带在不同状态下的移动情况。结果与对照组比较,SUI组膀胱颈移动度、膀胱尿道后角、尿道旋转角、肛提肌裂孔面积显著性增大,尿道长度显著性缩短,尿道漏斗形成率也显著增高(P0.05);SUI组手术前后比较,TVT-O术后患者尿道长度在静息及Valsalva动作下与术前比较有显著性增加,(P0.05),并接近对照组(P0.05);TVT-O手术后患者尿道旋转角接尿道口漏斗形成率较术前显著性下降(P0.05),但未达到正常水平(P0.05)。结论经会阴实时三维超声影像技术可用于女性SUI患者的术前评估、术后疗效评估及TVT-O吊带位置形态观察和随访。
[Abstract]:Objective to evaluate the clinical value of transperineal real-time three-dimensional ultrasound in the evaluation of preoperative and postoperative outcomes in female patients with stress urinary incontinence (sui). Methods 32 patients with SUI and 32 patients with age matched healthy were collected. Kang female as control group, The control group and SUI group underwent real-time three dimensional transperineal ultrasonography before and 3 months after operation. The position of bladder neck, urethra, pelvic and phrenic fissure, and the shape of pubic visceral muscle were compared between the two groups in different states (resting Valsalva action). At the same time, the changes of bladder neck, urethra and the movement of sling in different states were compared before and after TVT-O. Results compared with the control group, the degree of bladder neck movement in the SUI group was higher than that in the control group. The posterior angle of bladder and urethra, the rotation angle of urethra, the area of fissure of levator ani muscle, the length of urethra were significantly increased, and the length of urethra was shortened significantly. The rate of urethral funnel formation was also significantly increased in the P0.05 SUI group before and after operation. The urethral length of the patients after TVT-O operation was significantly increased under rest and Valsalva compared with that before operation, and close to the urethral rotation angle junction urethral orifice after TVT-O operation in the control group. The rate of funnel formation was significantly lower than that before operation (P 0.05), but not up to the normal level (P 0.05). Conclusion the transperineal real-time three-dimensional ultrasound imaging can be used for preoperative evaluation of female patients with SUI. Postoperative efficacy and TVT-O sling location were observed and followed up.
【作者单位】：中山大学附属第三医院泌尿外科;
【基金】：广东省自然科学基金资助项目(编号:2016A030313192)
【分类号】：R711.59

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