盆底超声参数检查初产妇产后发生盆底脏器脱垂的研究

Research on pelvic floor ultrasound parameters to examine the occurrence of pelvic floor organ prolapse in primiparous women after delivery

摘要

目的 探讨盆底超声参数对初产妇产后发生盆底脏器脱垂的诊断价值。方法 收集2020年1月到2022年12月成都医学院第二附属医院·核工业四一六医院收治的盆底脏器脱垂初产妇135例并纳入脱垂组;收集同时期该院妇产科收治的非盆底脏器脱垂初产妇135例并纳入非脱垂组,对所有患者均开展盆底超声检查,并对比盆底超声参数(盆膈裂孔面积、尿道倾斜角、肛直角),分析盆底超声参数在盆底脏器脱垂中的诊断价值。结果 在静息状态下和Valsalva状态下,脱垂组与非脱垂组的盆膈裂孔面积和尿道倾斜角比较差异均有统计学意义(t值分别为58.190、13.027、76.720、8.148,P<0.05),而两组的肛直角比较差异均无统计学意义(P>0.05).经受试者工作特征(ROC)曲线分析显示,静息状态下和Valsalva状态下盆底超声参数盆膈裂孔面积、尿道倾斜角、盆膈裂孔面积和尿道倾斜角联合诊断患者盆底脏器脱垂的AUC均大于0.80,诊断价值均较理想.超声参数盆膈裂孔面积、尿道倾斜角、盆膈裂孔面积和尿道倾斜角联合诊断患者为盆底脏器脱垂的静息状态下的特异度分别为0.993、0.993、0.993,灵敏度分别为0.704、0.896、0.874;Valsalva状态下的特异度分别为0.993、0.992、0.993,灵敏度分别为0.792、0.978、0.808。结论 盆底超声参数中的盆膈裂孔面积及尿道倾斜角在对盆底脏器脱垂患者诊断中具有重要作用,临床针对盆底脏器脱垂可疑患者可通过开展盆底超声检查,准确判断患者的病情状态.

Abstract

Objective To investigate the diagnostic value of pelvic floor ultrasound parameters for pelvic floor organ prolapse in primiparous women after delivery. Methods Baseline data were collected from 135 primiparous women with pelvic floor organ prolapse admitted to the Second Affiliated Hospital of Chengdu Medical College-Nuclear Industry 416 Hospital from January 2020 to December 2022. These women were categorized into the prolapse group. Additionally, baseline data from 135 primiparous women without pelvic floor organ prolapse treated in department of obstetrics and gynecology during the same period were collected and categorized into the non-prolapse group. All patients underwent pelvic floor ultrasound examination and compared pelvic floor ultrasound parameters (pelvic diaphragm fissure area, urethral tilt angle and anorectal angle), to analyze their diagnostic value for pelvic floor organ prolapse. Results At rest and during the Valsalva maneuver, the hiatal area and urethral inclination angle showed statistically significant differences between the prolapse and non-prolapse groups (t=58.190, 13.027, 76.720, and 8.148, respectively, P<0.05). However, there was no statistically significant difference in the anorectal angle between the two groups (P>0.05). Receiver operating characteristic (ROC) curve analysis showed that the AUC of pelvic floor ultrasound parameters such as pelvic diaphragm hiatus area, urethral tilt angle and combined pelvic diaphragm hiatus area and urethral tilt angle for diagnosing pelvic floor organ prolapse in patients under rest and Valsalva maneuver were all greater than 0.80, and the diagnostic value was ideal. The specificities of ultrasound parameters such as pelvic diaphragm hiatus area, urethral tilt angle and combined pelvic diaphragm hiatus area and urethral tilt angle in diagnosing pelvic organ prolapse in patients at rest were 0.993, 0.993 and 0.993, respectively, and the sensitivities were 0.704, 0.896 and 0.874, respectively. The specificities in Valsalva state were 0.993, 0.992 and 0.993, respectively, and the sensitivities were 0.792, 0.978 and 0.808 respectively. Conclusion The pelvic floor ultrasound parameters of pelvic diaphragmatic fissure area and urethral tilt angle play an important role in the diagnosis of patients with pelvic floor organ prolapse. For patients suspected of having pelvic organ prolapse, conducting a pelvic floor ultrasound examination can accurately determine their condition.

关键词

盆底脏器脱垂 / 彩色多普勒超声 / 参数 / 诊断

Key words

pelvic floor organ prolapse / color Doppler ultrasound / parameters / prediction

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