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目的:探讨经会阴三维超声评估耻骨直肠肌损伤与压力性尿失禁的相关性。方法:选取在该院妇产科及泌尿外科收治的盆底功能障碍患者143例。经实时三维超声检查,采用断层超声成像和阴道触诊来诊断耻骨直肠肌损伤情况,分析耻骨直肠肌损伤与压力性尿失禁的关系。结果:排除因数据丢失或不足11例外,132例患者获得完整超声数据,耻骨直肠肌损伤29例(21.97%),为损伤组。损伤组临床症状较少表现为压力性尿失禁,差异无统计学意义(P>0.05),更多表现为盆腔器官脱垂(P<0.05)。多元logistic回归分析显示,耻骨直肠肌损伤与压力性尿失禁无相关性,差异无统计学意义(P>0.05)。结论:在盆底功能障碍患者中,耻骨直肠肌损伤不是增加压力性尿失禁风险的预测指标。
Objective: To investigate the relationship between puborectalis injury and stress urinary incontinence assessed by three-dimensional perineal ultrasound. Methods: 143 cases of pelvic floor dysfunction admitted to obstetrics and gynecology and urology in this hospital were selected. Real-time three-dimensional ultrasound examination, the use of tomographic imaging and vaginal palpation diagnosis of puborectalis injury, the relationship between puborectalis injury and stress urinary incontinence. Results: Excluding the cases of missing or insufficient data, 132 cases obtained complete ultrasound data and 29 cases (21.97%) of puborectalis injury were injured group. The clinical symptoms of the injury group showed less stress urinary incontinence, the difference was not statistically significant (P> 0.05), and the more manifestations were pelvic organ prolapse (P <0.05). Multivariate logistic regression analysis showed no correlation between puborectalis injury and stress urinary incontinence, the difference was not statistically significant (P> 0.05). Conclusion: In patients with pelvic floor dysfunction, puborectalis injury is not a predictor of increased risk of stress urinary incontinence.