三维超声在产后压力性尿失禁诊断中的应用价值

目的:探讨产后压力性尿失禁(SUI)妇女盆膈裂孔的大小及耻骨内脏肌的厚度。方法:对43例产后SUI妇女行经会阴三维超声检查,并与48例无SUI症状的产妇作对照观察。测量两组产妇在静息、张力(Vasalva动作)和缩肛动作时的盆膈裂孔前后径、横径、面积及耻骨内脏肌厚度。结果:在静息、张力及缩肛动作3种状态下,SUI组盆隔裂孔前后径、面积均明显大于对照组(P<0.05或P<0.01);在张力状态时,SUI组盆膈裂孔横径明显大于对照组(P<0.05),在张力状态及缩肛动作时,SUI组耻骨内脏肌厚度均明显小于对照组(P<0.05)。结论:产后SUI患者盆膈裂孔增大,耻骨内脏肌厚度减小。经会阴三维超声是对产后SUI患者进行诊断的有效影像学检查方法。

Application value of three-dimensional ultrasound in diagnosis of postpartum women with stress urinary incontinence

Objective: To measure the size of pelvic diaphragm hiatus and thickness of pubovisceral muscle inpostpartum women with stress urinary incontinence(SUI)by transperineal three-dimensional(3D) ultrasound.Methods :3D sonographic data from 43 postpartum women with SUI were analyzed,and 48 postpartum women without SUI were chosen as control group.The anteroposterior diameter,transverse diameter and area of diaphragm hiatus were measured at rest,on Valsalva maneuver and maximum pelvic floor contraction,respectively.In addition,the thickness of pubovisceral muscle was measured at three maneuvers,respectively.Results: The anteroposterior diameter and area of pelvic diaphragm hiatus in women with SUI were significantly increased than those in women without SUI at three maneuvers,respectively(P<0.05 or P<0.01).The transverse diameter of diaphragm hiatus in SUI groups were significantly increased than those in control group on Valsalva maneuver.The pubovisceral muscle thickness in SUI group was significantly lower than that in control group on Valsalva maneuver and maximum pelvic floor contraction(P<0.05).Conclusion: The increased diameters of pelvic diaphragm hiatus and decreased thickness of pubovisceral muscle are observed in postpartum SUI women than in those non SUI women.The perineal 3D ultrasound is an effective examination method in the postpartum SUI women.