盆底三维超声辅助诊断女性压力性尿失禁的价值及对TVT-O效果的评估

发布时间：2018-05-08 13:48

本文选题：压力性尿失禁 + 经闭孔无张力尿道中段悬吊术　；参考：《中国老年学杂志》2015年20期

【摘要】：目的分析盆底三维超声对压力性尿失禁(SUI)的诊断价值以及对经闭孔无张力尿道中段悬吊(TVT-O)手术效果的评价作用。方法测量118例SUI患者术前和术后及100例阴性对照组盆底结构二维和三维超声数据指标,评估膀胱尿道连接部的直接移动度(UVJ-M)、静息期及Valsalva动作后膀胱尿道后角、耻骨直肠肌厚度、盆膈裂孔面积,并观察两组肛提肌形态和TVT-O术后植入吊带的形态。结果 SUI组UVJ-M、Valsalva动作后膀胱尿道后角较对照组增大(P0.05);静息期及Valsalva动作后耻骨直肠肌厚度小于对照组(P0.05);静息期SUI组盆膈裂孔面积与对照组无显著性差异(P0.05),Valsalva动作后SUI组盆膈裂孔面积大于对照组(P0.05);SUI组TVT-O术后吊带位置、形态及活动情况可清晰观察,TVT-O术后UVJ-M小于术前(P0.05),Valsalva时吊带的位置和形态无明显改变,可在尿道中段形成闭合效应,盆膈裂孔面积较术前无统计学差异。结论三维超声显像能直观有效地观察女性盆底结构,对诊断SUI是一个良好的辅助手段;并可为TVT-O术后评估提供更好依据。
[Abstract]:Objective to analyze the diagnostic value of pelvic floor three-dimensional ultrasound in patients with stress urinary incontinence (sui) and evaluate the effect of TVT-O surgery. Methods the two dimensional and three dimensional ultrasound data of pelvic floor structure were measured in 118 patients with SUI before and after operation and 100 patients with negative control group. The direct mobility of bladder and urethral junction, the posterior horn of bladder urethra and the thickness of puborectum muscle during resting period and after Valsalva were evaluated. The area of pelvic and phrenic fissure, the shape of levator ani muscle and the shape of sling after TVT-O were observed. Results the posterior angle of bladder urethra in SUI group was larger than that in control group (P 0.05), the thickness of pubic rectum muscle in rest period and Valsalva was lower than that in control group (P 0.05), and there was no significant difference in the area of pelvic and phrenic fissure between SUI group and control group in resting period. The area of the pelvic diaphragm hole was larger than that of the control group (P 0.05) and the position of the sling band after TVT-O in the SUI group. The position and shape of the sling were not changed when the UVJ-M after TVT-O was less than that before operation (P 0.05), and the closure effect could be formed in the middle urethra. There was no significant difference in the area of the laceration of the pelvis and diaphragm between the two groups. Conclusion Three-dimensional ultrasound imaging can directly and effectively observe the pelvic floor structure of female, and is a good assistant method for the diagnosis of SUI, and can provide a better basis for the evaluation after TVT-O.
【作者单位】：西安交通大学第二附属医院泌尿外科;西安交通大学第二附属医院;西安交通大学第二附属医院超声科;西安交通大学第二附属医院妇产科;
【基金】：西安医科大学科学技术项目(2014-31)
【分类号】：R699.7

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