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目的探讨不同膀胱容量对女性压力性尿失禁(SUI)各项超声指标的影响以及超声在女性SUI诊断中的应用价值。方法对2005年6月至2007年3月南京军区福州总医院妇产科收治的42例SUI患者(SUI组),选择其中10例,禁水、禁食4h,逆行膀胱灌注(100、200、300、500mL);选择同期收住院的无SUI和(或)盆腔器官脱垂,因子宫良性肿瘤行子宫切除术的患者35例为对照组。分别在安静状态下和屏气用力动作时,采用经会阴超声检测患者膀胱颈的移动度(Mu)、膀胱颈至耻骨联合后缘中点的距离(Br、Bs),并将两种状态下的图像冻结并储存入计算机;运用计算机程序测量两种状态下的尿道膀胱后角(αr、αs)和膀胱颈的旋转角度(θ)。结果不同膀胱容量的各项超声指标检测结果类似(P>0.05)。SUI组与对照组安静及屏气用力状态时Mu、Br、Bs、αr、αs、θ、ΔB(Br与Bs的差值)值分别为(1.61±0.31)cm、(3.86±0.67)cm、(4.80±0.69)cm、(118.33±9.48)°、(134.93±14.67)°、(30.31±4.05)°、(0.91±0.14)cm与(0.91±0.17)cm、(2.64±0.37)cm、(2.92±0.42)cm、(93.66±6.52)°、(103.29±9.23)°、(15.83±2.58)°、(0.27±0.13)cm,两组各项指标比较差异均有统计学意义(P<0.01)。SUI组Mu、ΔB、θ与SUI的严重程度呈正相关(r分别=0.884,0.908,0.838,P<0.01)。结论(1)不同膀胱容量对女性SUI的各项超声指标无影响。(2)尿道高活动性是SUI的病因之一。(3)会阴超声在SUI的诊断中具有重要的应用价值。
Objective To investigate the effect of different bladder volume on various ultrasound indexes of female stress urinary incontinence (SUI) and the value of ultrasound in the diagnosis of SUI in women. Methods Forty - two SUI patients (SUI group) admitted to Fuzhou General Hospital of Nanjing Military Region from June 2005 to March 2007 were selected, 10 of them were treated with water, fasted for 4 hours, retrograde bladder perfusion (100, 200, 300,500mL); 35 patients with SUI and / or pelvic organ prolapse admitted in the same period and hysterectomy due to uterine benign tumor were selected as the control group. (Mu), the distance between the bladder neck and the midpoint of posterior margin of the pubic symphysis (Br, Bs) were measured by perineal ultrasound and the distance between the bladder neck and the pubic symphysis midpoint (Br, Bs) The images were frozen and stored in the computer; computer programs were used to measure urethral bladder angle (αr, αs) and bladder neck rotation angle (θ) in both states. Results of different bladder capacity of the ultrasound test results were similar (P> 0.05). The values of Mu, Br, Bs, αr, αs, θ and ΔB (1.61 ± 0.31) cm and (3.86 ± 0.67) cm in SUI group and control group were 4.80 ± 0.69 cm, 118.33 ± 9.48 °, 134.93 ± 14.67 °, 30.31 ± 4.05 °, 0.91 ± 0.14 cm, and (0.91 ± 0.17) cm, (2.64 ± 0.37) cm, ± 0.42) cm, (93.66 ± 6.52) °, (103.29 ± 9.23) °, (15.83 ± 2.58) ° and (0.27 ± 0.13) cm respectively, with significant differences between the two groups (P <0.01) . Mu, ΔB, θ in SUI group were positively correlated with the severity of SUI (r = 0.884,0.908,0.838, P <0.01). Conclusions (1) Different bladder capacities have no effect on the ultrasound indexes of female SUI. (2) High urinary tract activity is one of the causes of SUI. (3) Perineal ultrasound in the diagnosis of SUI has an important application value.