摘要
目的:利用经会阴超声对女性盆底结构的检查成像,分析压力性尿失禁(SUI)患者盆底结构变化,探讨超声对于SUI的诊断价值。方法:选择2019年1月至2020年6月就诊于中国医科大学附属盛京医院诊断为SUI的患者214例为病例组,选择同期就诊于本院排除SUI的患者118例为对照组。对两组患者分别行经会阴超声检查,比较相关超声参数,并用受试者工作特征(ROC)曲线分析超声的诊断价值。结果:病例组Valsalva状态下膀胱颈及膀胱最低点距参考线距离、膀胱颈移动度、膀胱后角开放率、尿道漏斗形成率、肛提肌裂孔面积均高于对照组(P<0.05)。对病例组按SUI程度进一步划分为轻、中、重度三组,各组之间各超声参数差异均无统计学意义(P>0.05)。ROC曲线分析示,病例组与对照组间存在差异的超声指标均对SUI的诊断具有一定价值(P<0.05);联合参数诊断SUI的曲线下面积(AUC)0.891,敏感度70.09%、特异度96.61%,优于单一参数的诊断价值。结论:经会阴超声能够准确直观地观察膀胱颈及尿道周围的支持结构,测量的相关参数与SUI的发生相关,但与其严重程度无关。超声检查能够为SUI的诊断提供重要影像依据,但其对于SUI的诊断预测价值较为有限。
Objective:To analyze the pelvic floor structure changes in stress urinary incontinence(SUI)patients by transperineal ultrasound imaging,and investigate the clinic diagnostic value of ultrasound.Methods:A total of 214 patients diagnosed with SUI in Shengjing Hospital of China Medical University between January 2019 to June 2020 were selected into the case group,and 118 patients with non-SUI in the same period were selected into the control group.Transperineal ultrasound was performed in both groups.All the ultrasonic parameters were compared between the two groups,and the diagnostic predictive value for SUI of each ultrasonic parameter was analyzed by ROC curve.Results:Compared with the control group,bladder neck symphyseal distance,bladder lowest point symphyseal distance,bladder neck descent,retrovesical angle,the rate of bladder neck funnel formation,and levator hiatus area in the case group were significantly higher at Valsalva status(P<0.05).The case group was further dividing into the mild,moderate,and severe subgroup according to the degree of SUI,there was no significant difference in ultrasonic parameters among the three groups(P>0.05).ROC curve analysis showed that all the ultrasonic parameters above had a certain value in diagnosis of SUI(P<0.05).The area under the curve(AUC)of the combined parameters for the diagnosis of SUI was 0.891,with a sensitivity of 70.09%and specificity of 96.61%,which was greater than the diagnostic value of any single parameter.Conclusions:Transperineal ultrasound can provide accurate and intuitive visualization of the supporting structures around the bladder neck and urethra.The ultrasonic parameters are relevant to the occurrence of SUI,but not its severity.Ultrasonography can provide an important imaging basis for the diagnosis of SUI,while its predictive value for the SUI diagnosis is relatively limited.
作者
史畅
夏志军
SHI Chang;XIA Zhijun(Department of Obstetrics and Gynecology,Shengjing Hospital of China Medical University,Shenyang Liaoning 110004,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2021年第1期52-56,共5页
Journal of Practical Obstetrics and Gynecology
关键词
压力性尿失禁
盆底解剖
经会阴超声
Stress urinary incontinence
Pelvic floor anatomy
Pelvic floor ultrasound
