陈英　胡洋

[摘要] 目的 探討经会阴二维超声对压力性尿失禁女性患者盆底效果。 方法 选择2017年1～10月在我院诊断治疗的压力性尿失禁患者60例为研究对象，另选择同期健康体检者50例为对照组。均行经会阴二维超声盆底动态观察，比较两组相关指标。 结果 在静息状态下观察组X值显著高于对照组、∣Y∣值显著低于对照组，差异有统计学意义（P<0.05）；观察组尿道弯曲处至横坐标距离小于对照组，差异显著（P<0.05）；观察组尿道成角显著小于对照组（P<0.05）。在Valsalva时与缩肛时观察组X值显著高于对照组、∣Y∣值显著低于对照组，近段尿道长度较对照组短，差异有统计学意义（P<0.05）；观察组尿道弯曲处至横坐标距离与对照组在相反的方向，数据比较差异显著（P<0.05）；观察组尿道成角显著小于对照组（P<0.05）。 结论 压力性尿失禁患者会阴二维超声动态观察显示膀胱颈、尿道向后下方移，在Valsalva状态以及缩肛状态尿道缩短，在Valsalva状态下尿道口形成漏斗均与尿失禁有关。

[关键词] 经会阴二维超声；压力性尿失禁；盆底；缩肛状态

[中图分类号] R694；R445.1 [文献标识码] B [文章编号] 1673-9701（2018）15-0101-04

Dynamic observation results analysis of pelvic floor in women with stress urinary incontinence by two-dimensional perineal ultrasound

CHEN Ying HU Yang

Department of Urology， Jinhua Central Hospital in Zhejiang Province， Jinhua 321000， China

[Abstract] Objective To investigate the effect of two-dimensional perineal ultrasound in pelvic floor in female patients with stress urinary incontinence. Methods 60 patients with stress urinary incontinence who were diagnosed and treated in our hospital from January to October 2017 were selected as the research objects. Another 50 healthy subjects in the same period were selected as the control group. All patients pelvic floors were under dynamic observation by the perineal two-dimensional ultrasound. The related indicators between two groups were compared. Results In resting state， the value of X in the observation group was significantly higher than that in the control group， and the value of |Y| was significantly lower than that in the control group， with significant difference（P<0.05）. The distance from the urethra bending to abscissa in the observation group was significantly smaller than that of the control group（P<0.05）. The urethral angulation in the observation group was significantly smaller than that of the control group（P<0.05）. In Valsalva and anal contraction state， the value of X in observation group was significantly higher than that in control group ，and the value of ∣Y∣ was significantly lower than that of the control group， and the length of the proximal urethra was shorter than that of the control group. The difference was statistically significant（P<0.05）. The distance from urethral bending to the abscissa in the observation group was in the opposite direction of that of the control group， and the difference was significant（P<0.05）. The urethra angulation of the observation group was significantly smaller than that of the control group（P<0.05）. Conclusion The dynamic observation of the perineal two-dimensional ultrasound in patients with stress urinary incontinence shows that bladder neck and urethra move backward and downwards， and the urethra shortens in Valsalva and anal contraction state. It also shows that funnel change of urethra is related to urinary incontinence in Valsalva state.

[Key words] Two-dimensional perineal ultrasound； Stress urinary incontinence； Pelvic floor； Anal contraction state

压力性尿失禁是负压增加时不自主的尿失禁，女性人群中23%～45%有不同程度的尿失禁，7%左右有明显的尿失禁症状，其中约50%为压力性尿失禁[1]。女性患者盆底功能紊乱是压力性尿失禁的主要原因[2，3]。目前临床上对压力性尿失禁的诊断主要有尿动力学检查、超声、磁共振检查。超声具有检查结果客观、费用少、实施可重复等优点而被广泛肯定。本研究分析经会阴二维超声检查女性压力患者盆底相关参数，以期为临床诊断提供依据。现报道如下。

1 资料与方法

1.1 一般资料

选择2017年1～10月在我院诊断治疗的压力性尿失禁患者60例为研究对象，另选择同期健康体检者50例为对照组，均为女性。压力性尿失禁患者为观察组，纳入标准：有压力性尿失禁症状，压力试验阳性，尿垫试验>1 g；尿动力学检查证实诊断。排除标准：腰腹部外伤病史，脊柱腰骶部外伤史，妇科检查合并Ⅱ度以上盆腔器官脱垂；尿动力学检查证实膀胱逼尿肌不稳。观察组年龄28～65岁，平均（46.7±9.3）岁；……