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目的探讨应用经会阴实时三维超声观察膀胱颈在压力性尿失禁中的诊断标准及价值。方法 283例压力性尿失禁患者作为病例组,72例无症状者为对照组,两组患者均应用经会阴实时三维超声检查,测量静息及最大Valsalva状态膀胱颈位置,计算膀胱颈移动度,评估其在压力性尿失禁中的诊断标准及价值。结果病例组、对照组静息时膀胱颈位置为(28.1±3.1)mm/(27.7±3.2)mm,最大Valsalva状态膀胱颈位置(-1.6±10.3)mm/(11.5±6.0)mm,膀胱颈移动度为(29.7±10.3)mm/(15.8±6.6)mm。静息状态两组结果比较无统计学差异(P>0.05),最大Valsalva状态膀胱颈位置、膀胱颈移动度两组结果比较有显著差异(P<0.05)。应用受试者工作特性曲线(ROC)分析,最大Valsalva状态膀胱颈位置及膀胱颈移动度诊断压力性尿失禁的截断值分别为3、24mm,曲线下面积分别为0.855、0.866,灵敏度、特异度分别为68.1%、95.0%;70.0%、95.0%。结论最大Valsalva状态膀胱颈位置、膀胱颈移动度能用于压力性尿失禁诊断,诊断截断值分别为3、24mm,二者均具有较高的诊断价值。
Objective To investigate the diagnostic criteria and value of bladder neck in stress urinary incontinence by real-time three-dimensional perineal ultrasound. Methods 283 cases of stress urinary incontinence were selected as the case group and 72 cases asymptomatic as the control group. The two groups of patients underwent real-time three-dimensional ultrasound examination of the perineal cavity to measure the bladder neck position at resting and maximum Valsalva state, Assess its diagnostic criteria and value in stress urinary incontinence. Results The bladder neck position was (28.1 ± 3.1) mm / (27.7 ± 3.2) mm and the maximum Valsalva bladder neck position was (-1.6 ± 10.3) mm / (11.5 ± 6.0) mm in the case group and the control group, The mobility is (29.7 ± 10.3) mm / (15.8 ± 6.6) mm. There was no significant difference between the two groups (P> 0.05). The results of bladder neck position and bladder neck movement in the maximal Valsalva state were significantly different (P <0.05). The receiver operating characteristic curve (ROC) analysis, the maximal Valsalva state bladder neck position and bladder neck mobility were 3,24mm, and the areas under the curve were 0.855,0.866, respectively. The sensitivity and specificity Respectively 68.1%, 95.0%; 70.0%, 95.0%. Conclusions The maximum Valsalva bladder neck position and bladder neck mobility can be used for the diagnosis of stress urinary incontinence. The diagnostic cutoffs are 3 and 24 mm respectively, both of which have high diagnostic value.