膀胱颈移动度在产后压力性尿失禁诊断中的应用及与病情严重程度的关系

发布时间：2018-08-08 11:56

【摘要】：目的探讨经会阴盆底超声测定膀胱颈移动度诊断产后压力性尿失禁(PSUI)的应用及与PSUI严重程度的关系。方法收集产后6~8周PSUI患者151例(PSUI组)及非PSUI产妇124名(对照组),应用经会阴超声测量静息状态和屏气向下用力至最大状态(瓦氏动作)膀胱颈至耻骨联合下缘的距离(BSD),计算膀胱颈移动度。比较两组间及PSUI不同严重程度间膀胱颈移动度,评价膀胱颈移动度对PSUI的诊断效能。结果PSUI组膀胱颈移动度[(34.98±7.75)mm]大于对照组[(23.32±7.08)mm],差异有统计学意义(t=7.35,P0.05)。膀胱颈移动度ROC曲线下面积为0.90,当截断值为32.50mm时,对PSUI的诊断效能最高,此时敏感度为85.71%,特异度为90.24%,阳性似然比为8.97,阴性似然比为0.14。轻、中、重度PSUI膀胱颈移动度差异有统计学意义(F=24.72,P0.05)。结论经会阴超声测定膀胱颈移动度在PSUI的诊断中价值较高;膀胱颈移动度与PSUI严重程度相关。
[Abstract]:Objective to investigate the application of transperineal pelvic floor ultrasonography in the diagnosis of postpartum pressure urinary incontinence (PSUI) and its relationship with the severity of PSUI. Methods PSUI patients (PSUI group) and 124 non PSUI parturient women (control group) were collected from 6 to 8 weeks postpartum. The resting state and breath holding force down to the lower edge of pubic symphysis were measured by transperineal ultrasound. Distance (BSD), was used to calculate bladder neck mobility. To compare the degree of bladder neck movement between the two groups and the different severity of PSUI, and to evaluate the diagnostic efficacy of bladder neck mobility for PSUI. Results the degree of bladder neck mobility in PSUI group [(34.98 卤7.75) mm] was significantly higher than that in control group [(23.32 卤7.08) mm] (P 0.05). The area under the ROC curve of bladder neck mobility was 0.90. When the truncation value was 32.50mm, the diagnostic efficiency of PSUI was the highest. At this time, the sensitivity was 85.71, the specificity was 90.244.The positive likelihood ratio was 8.97, and the negative likelihood ratio was 0.14. There was significant difference in bladder neck mobility between mild, moderate and severe PSUI (P 0.05). Conclusion the value of transperineal ultrasonography in the diagnosis of bladder neck mobility in PSUI is higher, and the bladder neck mobility is correlated with the severity of PSUI.
【作者单位】：石河子大学医学院第一附属医院妇产科;
【基金】：2013年度科技惠民计划项目(2013GS650104)
【分类号】：R714.6;R445.1

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