女性压力性尿失禁患者盆底三维超声显像初步研究

目的:通过三维超声对正常未孕妇女及产后压力性尿失禁(SUI)患者的盆底结构显像,研究SUI患者的膀胱颈尿道活动度及肛提肌变化,评估三维超声显像对女性盆底病变的诊断价值.方法:分别对研究组和对照组行盆底结构三维超声检查,测量膀胱尿道连接部的直接移动度(UVJ-M)、张力期膀胱尿道后角、静息期及张力期耻骨直肠肌厚度、耻骨直肠肌夹角,观察肛提肌形态.结果:SUI研究组UVJ-M 15.93± 2.07mm,较对照组7.64± 1.37mm增大(P＜0.01),研究组张力期膀胱尿道后角145.90±22.03°,较对照组106.49±14.32°增大(P＜0.01),研究组静息期耻骨直肠肌厚度6.39±0.48小于对照组6.71±0.69(P＜0.05),研究组张力期耻骨直肠肌厚度6.13±0.49小于对照组6.64± 0.61(P＜0.05),静息期研究组耻骨直肠肌夹角70.08±3.15大于对照组69.45±2.19°,但无统计学意义(P＞0.05),张力期75.49±3.92大于对照组70.35±1.51° (P＜0.01).结论:三雏超声显像能直观有效地观察女性尿道、肛提肌等盆底结构,对诊断压力性尿失禁是一个有意义的辅助手段.

Investigation of Pelvic Floor in Female Stress Urinary Incontinence by Three-Dimentional Ultrasound

Objective: Observing pelvic floor by three-dimentional ultrasound in nulliparous women and postpartum stress urinary incontinence(SUI),to investigate the changes of the bladder neck and urethral mobility and the changes of levator ani caused by trauma.To assess the value of three-dimentional ultrasound in diagnosing female SUI.Methods: In control group and study group,we observed pelvic floor visualized by three-dimentional ultrasound and measured the mobility of urethrovesical junction(UVJ-M),poster urethrovesical angle during the Valsalva maneuver,measured pubovisceral muscle thickness and pubovisceral muscle angles at rest time and during the Valsalva maneuver,respectively.Results: In study group,UVJ-M 15.93±2.07mm is larger than control group 7.64±1.37mm(P<0.01),poster urethrovesical angle 145.90±22.03°is larger than control group 106.49±14.32°too(P<0.01).The pubovisceral muscle thickness of study group 6.39±0.48 mm is thinner than control group 6.71±0.69(P<0.05)at rest time,during the Valsalva maneuver study group 6.13±0.49 mm is thinner than control group 6.64±0.61 too(P<0.05).The angle of pubovisceral muscle in study group 70.08±3.15 at rest time is larger than control group 69.45±2.19°,but there is no significant difference(P>0.01).The angle 75.49±3.92°during the Valsalva maneuver is larger than control group 70.35±1.51°(P<0.01).Conclusions: It is direct to observe female pelvic floor by three-dimentional ultrasound imaging.It is a sensitive and effective method to diagnose SUI.