徐翠芳,温洁
XU Cuifang,WEN Jie

• 1:上海市浦东新区中医医院

摘要(Abstract)：

目的:探讨经盆底超声测量膀胱颈活动度与绝经期妇女压力性尿失禁(SUI)的相关性。方法:选择确诊SUI绝经期妇女作为SUI组(n=90),同期健康体检的绝经期妇女作为对照组(n=90),收集2组绝经期妇女年龄、体质量指数(BMI)、分娩方式、分娩次数、基础疾病及学历等资料,采用超声检测2组绝经期妇女平静状态和Valsalva动作时膀胱尿道后角、尿道倾斜角,2种状态之间尿道旋转角度、膀胱颈旋转角度及膀胱颈活动度;对SUI患者膀胱颈活动度进行ROC曲线分析;以SUI严重程度(轻、中、重度)为因变量,以分娩次数、膀胱颈活动度及Valsalva时尿道倾斜角为自变量,采用有序多元Logistic回归分析SUI严重程度的影响因素。结果:SUI绝经期妇女分娩次数,Valsalva动作时膀胱尿道后角、尿道倾斜角、尿道旋转角度、膀胱颈旋转角度及膀胱颈活动度均高于对照组(P <0. 05),而静息时尿道倾斜角则低于对照组(P <0. 05); SUI患者膀胱颈活动度诊断SUI的ROC曲线下面积为0. 799(95%CI为0. 862～0. 735,P <0. 001),cut off值为24. 31 mm;有序多元Logistic回归分析结果显示,膀胱颈活动度是影响SUI绝经期妇女疾病严重程度的独立危险因素(OR=13. 491,95%CI为2. 593～22. 691,P <0. 05)。结论:盆底超声检查膀胱颈活动度与绝经期SUI患者病情严重程度显著相关,对绝经期SUI的确诊具有较好的可行性。
Objective: To investigate the quantitative evaluation of the correlation between bladder neck mobility and stress urinary incontinence( SUI) in postmenopausal women. Methods: A total of90 menopausal women who were diagnosed with SUI chosen in the SUI group( n = 90). 90 healthy menopausal women during the same period were included in the health group( n = 90). General information was collected: age,BMI,way of delivery,number of delivery,disease history,and education background. Both groups underwent pelvic floor ultrasound pelvic examination for relief angle of bladder and urethra,tilt angle of urethra in tranquility and Valsalva movement; rotation angle of urethra,rotation angle of bladder neck,and mobility of bladder neck in between both conditions;ROC curve analysis was performed on the bladder neck mobility of SUI patients; using SUI severity( mild,medium,and advanced) as dependent variable,using number of delivery,bladder neck mobility,and tilt angle of urethra in Valsalva as independent variables,using sequential multiple Logistic regression analysis for the influencing factors of the severity of SUI. Results: The number of delivery,relief angle of bladder and urethra in Valsalva movement,tilt angle of urethra,rotation angle of urethra,rotation angle of bladder neck and mobility of bladder neck in the SUI group were all higher than that of control group( P < 0. 05); while the resting urethral tilt angle was significantly lower than that of control group( P < 0. 05). The area under the ROC curve of bladder neck mobility diagnosed SUI was 0. 799( 95% CI = 0. 956-0. 872,P < 0. 001),and the cut off value was 24. 31 mm.Sequential multiple Logistic regression analysis indicated that bladder neck mobility was the independent influence factors of SUI disease severity in menopause women( OR = 13. 491,95% CI =2. 593-22. 691,P < 0. 05). Conclusion: The pelvic floor ultrasound examination of bladder neck mobility is significantly associated with the severity of SUI in patients with menopause,and it is also feasible for the diagnosis of menopausal SUI.

关键词(KeyWords)： 尿失禁,压力性;绝经期;盆底超声;量化评估;膀胱颈活动度;相关性
urinary incontinence stress(SUI);menopause;pelvic floor ultrasound(PFD);quantitative evaluation;bladder neck activity;correlation

Abstract:

Keywords:

基金项目(Foundation): 浦东新区科技发展基金项目(PKJ2018-Y26)

作者(Author): 徐翠芳,温洁
XU Cuifang,WEN Jie

DOI: 10.19367/j.cnki.2096-8388.2020.09.021

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