盆底超声对剖宫产后压力性尿失禁特征的诊断效能及生物反馈疗效评估

王化义; 武云哲; 张忠梅; 胡江敏; 张宏煜

doi:10.7619/jcmp.20232279

盆底超声对剖宫产后压力性尿失禁特征的诊断效能及生物反馈疗效评估

Diagnostic efficacy of pelvic floor ultrasound in the characteristics of stress urinary incontinence after cesarean section and biofeedback efficacy evaluation

摘要

摘要:
目的探讨盆底超声参数对剖宫产后压力性尿失禁(SUI)的诊断效能及生物反馈疗效评估效能。
方法采用简单抽样方式选取行剖宫产的孕妇215例作为研究对象，根据产后是否发生SUI, 分为SUI组(n=88)和非SUI组(n=127)。SUI组实施生物反馈治疗。比较2组盆底超声参数。比较SUI组治疗前后的盆底超声参数。
结果 SUI组的膀胱颈移动度(BND)、尿道旋转角(URA)及Valsalva状态下的肛提肌裂孔面积(LHA)、膀胱尿道后角(PUVA)大于非SUI组，差异有统计学意义(P < 0.05)。88例剖宫产后SUI患者经生物反馈治疗后，总有效率为94.32%。SUI组治疗后的BND、URA及Valsalva状态下的LHA、PUVA小于治疗前，差异有统计学意义(P < 0.05)。BND、URA、LHA、PUVA预测生物反馈治疗剖宫产后SUI疗效的曲线下面积(AUC)分别为0.853、0.897、0.865、0.887。
结论盆底超声参数在诊断剖宫产后SUI和评估生物反馈治疗效果方面具有较高效能。

Abstract:
Objective To evaluate the diagnostic efficacy of pelvic floor ultrasound parameters in post-cesarean stress urinary incontinence (SUI) and biofeedback efficacy evaluation.
Methods A total of 215 pregnant women who underwent cesarean section were selected by simple sampling method. According to whether postpartum SUI occurred, they were divided into SUI group (n=88) and non-SUI group (n=127). The SUI group received biofeedback therapy. The ultrasonic parameters of pelvic floor were compared between the two groups. The ultrasound parameters of pelvic floor in the SUI group were compared before and after treatment.
Results Bladder neck descent (BND), urethral rotation angle (URA) as well as levator hiatal area (LHA) and posterior urethrovesical angle (PUVA) in Valsalva state of the SUI group were significantly higher than those in the non-SUI group (P < 0.05). After biofeedback therapy, the total effective rate of 88 patients with SUI after cesarean section was 94.32%. The BND, URA as well as LHA and PUVA in Valsalva state of the SUI group after treatment were significantly lower than those before treatment (P < 0.05). The area under the curve (AUC) of BND, URA, LHA and PUVA in predicting the effect of biofeedback on post-cesarean section SUI were 0.853, 0.897, 0.865 and 0.887, respectively.
Conclusion Pelvic floor ultrasound parameters are highly effective in diagnosing SUI after cesarean section and evaluating the effect of biofeedback therapy.

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