1. 重庆市超声分子影像重点实验室
2. 重庆医科大学附属第二医院超声科
3. 重庆医科大学附属第二医院妇产科
Published:2015,
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[1]胡丽蓉,冉海涛,胡丽娜,姚宗兰,张理智.盆底超声和肌电生理检查在女性压力性尿失禁中的临床应用[J].重庆医科大学学报,2015,40(12):1532-1536.
Hu Lirong, Ran Haitao, Hu Lina, et al. Clinical application of pelvic floor ultrasound and muscle electrophysiological examination in treating female stress urinary incontinence. [J]. Journal of Chongqing Medical University 40(12):1532-1536(2015)
[1]胡丽蓉,冉海涛,胡丽娜,姚宗兰,张理智.盆底超声和肌电生理检查在女性压力性尿失禁中的临床应用[J].重庆医科大学学报,2015,40(12):1532-1536. DOI: 10.13406/j.cnki.cyxb.000737.
Hu Lirong, Ran Haitao, Hu Lina, et al. Clinical application of pelvic floor ultrasound and muscle electrophysiological examination in treating female stress urinary incontinence. [J]. Journal of Chongqing Medical University 40(12):1532-1536(2015) DOI: 10.13406/j.cnki.cyxb.000737.
目的:探讨盆底超声和肌电生理检查在女性压力性尿失禁(female stress urinary incontinence
FSUI)中的临床应用意义。方法:对77例FSUI患者(病例组)和41例健康体检女性(对照组)经会阴盆底二维超声观察静息时膀胱颈有无漏斗形成、静息至Valsalva动作后膀胱颈、膀胱后角及近端尿道的动态变化情况;同时经盆底肌电生理检查评估盆底肌Ⅰ、Ⅱ类肌纤维肌力、疲劳度情况;并进行比较及分析各参数与是否发生FSUI的相关性。结果:病例组静息时膀胱颈漏斗形成率、静息至Valsalva动作后膀胱颈y轴位移(Δy)、静息时膀胱后角(α)、Valsalva动作后膀胱后角(β)、近端尿道旋转度(γ)均大于对照组
差异有统计学意义(P
<
0.05);病例组静息至Valsalva动作后膀胱颈x轴位移(Δx)略大于对照组
但差异无统计学意义(P
>
0.05);病例组和对照组盆底Ⅰ/Ⅱ类肌纤维肌力、疲劳度差异无统计学意义(P
>
0.05)
但异常率均较高。以盆底超声检查联合肌电生理检查各参数为自变量
对是否发生FSUI为因变量进行多因素logistic回归分析
发现与发生FSUI显著相关的参数为Δy(OR=5.444
95%CI=1.009
2
9.381
P=0.049)、膀胱颈漏斗形成(OR=2.789
95%CI=1.144
6
.803
P=0.024)、Ⅰ类肌纤维肌力(OR=0.372
95%CI=0.150
0
.924
P=0.033)。结论:盆底超声检查可实时动态观察FSUI患者盆底解剖学变化
提供丰富的影像学信息;盆底肌电生理检查能早期有效评估女性盆底肌功能
其指标异常甚至可在FSUI症状出现之前被检出
指导临床及时采取干预措施;二者结合可从解剖学和电生理学两方面对FSUI患者的盆底情况进行综合评估
在FSUI的预测、诊断、临床分型及治疗方式选择指导中均有重要意义。
Objective:To evaluate the efficacy of clinical application of pelvic floor ultrasound and muscle electrophysiological examination in treating female stress urinary incontinence(FSUI). Methods:Pelvic floor ultrasound and pelvic floor muscle electrophysiological examination were performed on 77 women with FSUI(case group) and 41 healthy women without FSUI(control group). The bladder neck with or without funnel was evaluated in resting state. Dynamic changes in the bladder neck and posterior angle of the bladder and the proximal urethra were observed. Type Ⅰ/Ⅱ pelvic floor muscle fibers strength and fatigue were detected with electrophysiological testing. Correlation between every parameter and FSUI was compared and analyzed. Results:Funnel formation rate of the bladder neck at resting state
y axis moving distance(Δy) of the bladder neck from resting state to valsalva maneuver
posterior angle of the bladder in resting state(α)
posterior angle of the bladder after valsalva maneuver(β) and rotation degree of the proximal urethra(γ) of case group were greater than those of the control group(P<0.05). x axis moving distance(Δx) from resting state to valsalva maneuver of case group was slightly greater than that of the control group
but without statistical significance differences(P >0.05). There was no statistical difference in type Ⅰ/Ⅱ muscle fibers strength and fatigue between case group and control group(P >0.05)
but the abnormal rate of both groups was significantly high. With pelvic ultrasound and muscle electrophysiological examination parameters as independent variables
and FSUI occurrence as dependent variable
the multiple factors logistic regression analysis found that Δy(OR=5.444
95%CI=1.009 to 29.381
P=0.049)
funnel formation of the bladder neck(OR=2.789
95%CI=1.144 to 6.803
P=0.024)and the type Ⅰ pelvic floor muscle fibers strength(OR=0.372
95%CI=0.150 to 0.924
P=0.033) were significantly related to FSUI occurrence. Conclusion : Pelvic floor ultrasound can observe FSUI pelvic anatomy change real-time and dynamically
providing rich imaging information. Pelvic floor muscle electrophysiological examination can evaluate the female pelvic floor muscle function at early stage effectively;its abnormal parameters can be checked before symptoms of FSUI occur. Pelvic floor ultrasound combined with muscle electrophysiological examination can provide comprehensive evaluation on pelvic floor of FSUI patients
which is great importance in prediction
diagnosis
clinical classification and treatment of FSUI.
女性盆底功能障碍性疾病女性压力性尿失禁盆底超声检查盆底肌电生理检查
pelvic floor dysfunctionfemale stress urinary incontinencepelvic floor ultrasoundpelvic floor muscle electrophysiological examination
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