盆底超声对产后压力性尿失禁患者前腔室结构的观察

发布时间：2018-06-21 09:49

  本文选题：盆底超声 + 压力性尿失禁　； 参考：《中华全科医学》2016年08期

【摘要】：目的探讨盆底超声在观察产后近期压力性尿失禁患者前腔室结构变化的应用价值。方法随机选取经阴道自然分娩、并在产后6~8周接受产后复查的初产妇182例进行经会阴盆底超声检查,其中压力性尿失禁组(SUI组)72例,对照组110例。观察静息状态下及最大Valsalva动作时前腔室结构的超声改变。超声观察及测量的参数包括:静息状态下膀胱颈位置、逼尿肌厚度、膀胱后角以及最大Valsalva动作时膀胱颈的移动度、尿道旋转角、有无尿道内口漏斗形成、有无膀胱膨出。结果静息状态下SUI组的逼尿肌厚度为(3.21±0.86)mm,对照组为(3.11±0.76)mm,2组差异无统计学意义(t=0.798,P=0.426),但静息状态下SUI组膀胱颈位置更低[(23.61±4.57)mm vs.(25.35±4.05)mm]、膀胱后角更大[(134.14±21.04)°vs.(114.29±10.53)°],差异有统计学意义(t值分别为-2.697、8.422,P值分别为0.008、0.000)。最大Valsalva动作时膀胱颈移动度[(30.39±8.37)mm vs.(21.82±7.65)mm]和尿道旋转角[(45.21±12.78)°vs.(33.25±14.58)°]SUI组均较对照组明显增大,2组比较差异有统计学意义(t值分别为7.115、5.673,P值均为0.000),尿道内口漏斗形成率(55.56%vs.30.00%)、膀胱膨出率(63.89%vs.24.55%)SUI组亦增高,差异均有统计学意义(χ2值分别为11.831、28.041,P值分别为0.001、0.000)。结论产后压力性尿失禁的发生与膀胱颈、尿道支持结构及肛提肌的损伤有关。利用盆底超声动态观察前腔室结构和功能状态,可早期发现盆底组织异常改变,为临床及早诊治产后压力性尿失禁提供客观依据。
[Abstract]:Objective to investigate the value of pelvic floor ultrasound in observing the changes of anterior chamber structure in patients with postpartum stress urinary incontinence. Methods 182 cases of primipara undergoing postpartum reexamination at 6 and 8 weeks after delivery were randomly selected for transperineal pelvic floor ultrasound examination. 72 cases in the SUI group and 110 cases in the control group in the stress urinary incontinence group were examined by transperineal pelvic floor ultrasound. The ultrasonic changes of anterior chamber structure were observed at rest and maximum Valsalva motion. The parameters included bladder neck position, detrusor thickness, bladder posterior angle and the movement of bladder neck during maximum Valsalva movement, urethral rotation angle, urethral funnel formation and vesicocele. Results the detrusor thickness of SUI group was 3.21 卤0.86 卤0.86 mm in resting state, while that in control group was 3.11 卤0.76 mm, but the position of bladder neck in SUI group was lower [23.61 卤4.57)mm vs.(25.35 卤4.05)mm] and the posterior horn of bladder was larger [134.14 卤21.04 掳vs.(114.29 卤10.53 掳]. The bladder neck movement degree [30.39 卤8.37)mm vs.(21.82 卤7.65)mm] and the urethral rotation angle [45.21 卤12.78 掳vs.(33.25 卤14.58 掳] in the maximal Valsalva movement group were significantly larger than those in the control group. The significant difference was found between the two groups (P = 7.115, 5.673P, P = 0.000,55.56vs.30.00,65.56vs.30.00,63.89vs.24.55SUI). The difference was statistically significant (蠂 ~ 2 = 11.831 卤28.041) (P = 0.001 ~ 0.000). Conclusion postpartum stress urinary incontinence is related to the injury of bladder neck, urethral supporting structure and levator ani muscle. Dynamic observation of the structure and function of anterior chamber by pelvic floor ultrasound can early find abnormal changes of pelvic floor tissue and provide objective basis for early diagnosis and treatment of postpartum stress urinary incontinence.
【作者单位】： 广东药学院附属第一医院超声科;
【基金】：广东省医学科研基金资助项目(A2014366)
【分类号】：R445.1;R714.6
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本文编号：2048166