摘要
目的 探究Valsalva动作下盆底超声参数和腹直肌分离度(DRA)与初产妇产后压力性尿失禁(PSUI)及病情的关系.方法 选取产后 6～8 周至本院进行检查的初产妇 221 例,根据是否出现PSUI将产妇分为PSUI组(n=43)和对照组(n=178),检测并比较 2 组患者Valsalva动作下膀胱尿道后角(PVA)、尿道旋转角(URA)、膀胱颈移动度(BND)及DRA,并分析其与病情的关系.采用受试者工作特征(ROC)曲线分析PVA、URA、BND及DRA的诊断价值.结果 PSUI组Valsalva动作下PVA、URA、BND及DRA高于对照组(P<0.05).ROC曲线分析显示,Valsalva动作下PVA、URA、BND及DRA联合诊断PSUI的曲线下面积(AUC)为 0.823,高于各指标单独诊断价值(Z=2.43、2.53、2.68 和 2.50,P<0.05).不同病情程度PSUI患者PVA、URA、BND和DRA差异有统计学意义(P<0.05),且中度组、重度组的PVA、URA、BND和DRA均高于轻度组(均P<0.05),重度组BND和DRA均高于中度组(均P<0.05).结论 Valsalva动作下PVA、URA、BND与DRA联合检查可作为PSUI的辅助诊断参数,且与病情程度相关.
Abstract
Objective To investigate the correlation of pelvic floor ultrasound parameters under Valsalva exer-cise and diastasis recti abdominis(DRA)with postpartum stress urinary incontinence(PSUI)and its severity in primi-paras.Methods A total of 221 primiparas who came to our hospital for examination at 6-8 weeks postpartum were selected and divided into PSUI group(n=43)and control group(n=178)according to the presence or absence of PSUI.The posterior vesicourethral angle(PVA),urethral rotation angle(URA),bladder neck mobility(BND)under the Val-salva maneuver,and DRA were detected and compared between the two groups,and their relationship with the disease was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of PVA,U-RA,BND,and DRA,and the relationship between them and the severity of the condition was analyzed.Results PVA,URA,BND,and DRA were higher in the PSUI group than those in the control group(P<0.05).ROC curve analysis showed that the area under the curve of the combination of PVA,URA,BND,and DRA in the diagnosis of PSUI was 0.823,which was higher than that of each index alone(Z=2.43,2.53,2.68 and 2.50,P<0.05).There were significant differences in PVA,URA,BND,and DRA in patients with different severity of PSUI(P<0.05),and the PVA,URA,BND and DRA in the moderate group and the severe group were higher than those in the mild group(all P<0.05),and the BND and DRA in the severe group were higher than those in the moderate group(all P<0.05).Conclusion The combination of PVA,URA,BND,and DRA under the Valsalva maneuver can be used as auxiliary diagnostic parame-ters for PSUI,and it is correlated with the severity of PSUI.
维普
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