尿流动力学与盆底三维超声对女性压力性尿失禁临床诊断价值的对比研究

目的探讨尿流动力学与三维超声在女性压力性尿失禁（SUI）临床诊断价值方面的差异，提高该疾病的诊治水平。方法对5l例临床诊断压力性尿失禁的经产妇分别进行尿流动力学及盆底三维超声检查，分析尿流动力学指标（最大尿道压、最大尿道闭合压、功能性尿道长度、AIPP）、三维超声检查指标（盆膈裂孔的前后径、左右径、面积及耻骨内脏肌的厚度T1、T2，夹角0）与女性压力性尿失禁严重程度的关系；同时对尿流动力学和三维超声检查临床诊断价值进行对比。结果多项logistic分析发现尿流动力学各指标均为影响SUI程度的相关指标，功能性尿道长度为主要影响因素（似然比为0．001）。而在三维超声指标中，在Valsalva动作时，面积A、骨内脏肌的厚度T1与SUI程度相关，T1为主要影响指标（似然比为0．001）。ROC曲线明确尿流动力学诊断价值为0．88，较静息和Valsalva下三维超声的诊断价值高（0．88VS0．58）。结论尿流动力学检查在女性压力性尿失禁的诊断中具有重要的价值，特别是功能性尿道长度的测量能有效地进行严重程度的预判。三维超声技术为压力性尿失禁的评价开辟了新的途径，仍需标准化的检查途径，获得更高的可信度及可重复性。，

A Comparative study of urodynamics ultrasound for diagnosis of female and pelvic three- dimensional stress urinary incontinence

Objective To compare the clinical diagnostic value of urodynamics and pelvic three - dimensional ultrasound in female stress urinary incontinence（SUI）. Methods Clinical data of 51 cases with SUI was analyzed retrospectively including parameters such as maximum urethral pressure（MUP） ,rnaxinmm urethral closure pressure（MUCP） , functional urethral length（ FUL）, ALPP of urodynamies and parameters of three - dimensional uhrasound such as the anteroposterior diameter（M） ,left to fight diameter（N） and area of the pelvic diaphram hiatus（A） ,the thickness and angle between the branches of pubovis~：eral muscles （ T1, T2,7） , in order to confirm the correlation between SUI level and tha above param- eters as well as comparing the clinical value .f the two examillations. Results In the logistic regression analysis,all pa- rameters of urodynamics were found to be independent predictors of the SUI level and FUL was the main factor of predic- tors（ OR 0. 001 ）. The pelvic diaphram hiatus（A） and the thickness of pubovisceral muscles（ T1 ） were tound the inde- pendent predictors with the key factor T1 under Valsalva movement （OR 0. 001 ）. Clinical value of urodynamies was higher than three - dimensional nhrasound determined by ROC （ AUC 0. 88 vs 0. 58 ）. Conclusions Urodynamics is still one valuable diagnositic method of stress nrinary incontinence,and can predict the severity of SUI with functional urethral length（FUL）. Three - dimensional uhrasound has a promising prospect for evaluation of stress urinary incontinence with improved standard process.