盆底超声在女性压力性尿失禁中的应用及初产妇产后盆底肌肉训练的疗效评估

目的 研究盆底超声在女性压力性尿失禁(SUI)中的应用以及对采用盆底肌肉训练进行治疗的效果。 方法 选取2017年4—12月于湖州市妇幼保健院接受检查的初产妇1 000例，筛选出SUI患者273例，统计盆底超声诊断效能，并制定盆底肌肉训练方案，6个月后复查时按是否坚持进行康复锻炼将所有SUI患者分为对照组和治疗组，采用盆底超声对2组患者的盆底及膀胱周围结构数据进行观察统计，并比较治疗效果。 结果 盆底超声诊断特异度、灵敏度和准确度均较高；静息状态下，治疗组患者尿道倾斜角、膀胱尿道后角小于对照组，膀胱颈位置、膀胱位置高于对照组，尿道内口漏斗形成率低于对照组(均P＜0.05)；最大Valsalva动作下，治疗组患者膀胱颈下降距离、尿道旋转角、膀胱尿道后角和膀胱下降位置均小于对照组，尿道内口漏斗形成率低于对照组(均P＜0.05)；治疗组治疗总有效率高于对照组(P＜0.05)。 结论 盆底超声对SUI症状诊断效能较高，并能清晰显示盆底结构，根据患者SUI的具体情况选择合适的治疗方式，可为SUI患者的早期诊断和治疗提供帮助。 

Application of pelvic floor ultrasound in female stress incontinence and evaluation of efficacy of postpartum pelvic floor muscle training

Objective To study the application of pelvic floor ultrasound in female stress urinary incontinence (SUI) and evaluate the effect of pelvic floor muscle training. Methods From April 2017 to December 2017, 1 000 primipara who were examined in our hospital were selected. The diagnostic efficacy of pelvic floor ultrasound was counted. Pelvic floor muscle training program was formulated. After 6 months, all SUI patients were divided into control group and treatment group. Pelvic floor ultrasound was used to observe the pelvic floor and peri-bladder structure data of the two groups, and the therapeutic effect was compared. Results The specificity, sensitivity and accuracy of pelvic floor ultrasonography diagnosis were higher; in resting state, the urethral inclination angle and posterior angle of bladder and urethra in treatment group were smaller than those in control group, the position of bladder neck and bladder was higher than that in control group, and the formation rate of funnel in urethra was lower than that in control group (all P<0.05); under maximum Valsalva maneuver, the descending distance of bladder neck, the rotation angle of urethra and bladder urine in the incidence of funnel formation was lower in the treatment group than in the control group (all P<0.05), and the total effective rate in the treatment group was higher than that in the control group (P<0.05). Conclusion Pelvic floor ultrasound has a high diagnostic efficiency for SUI symptoms, and can clearly show the pelvic floor structure. According to the specific conditions of patients with SUI, appropriate treatment methods are selected to provide help for early diagnosis and treatment of SUI patients.