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目的监测妊娠期及产后膀胱颈移动度的大小,评价妊娠期膀胱颈移动度对产后压力性尿失禁的预测价值。方法 2014年6—12月在唐山市妇幼保健院初孕妇240例,分别于孕34、36、38周及产后6周,经阴唇三维实时超声监测膀胱颈移动度。结果 1 240例纳入研究,压力性尿失禁组88例,平均年龄(25.8±2.12)岁,孕34周前平均BMI为23.5±2.01。非压力性尿失禁组152例,平均年龄(24.7±1.91)岁,孕34周前平均BMI为23.1±2.45。二组间一般资料比较具有可比性(P>0.05)。妊娠晚期压力性尿失禁患病比率及尿道膀胱颈移动度的变化:1妊娠晚期各阶段及产后SUI患病比率:孕34、36、38周,产后6周SUI患病比率分别为6.7%(16/240)、17.5%(42/240)、45.8%(110/240)、7.5%(18/240),随孕周的增加SUI患病比率逐渐增加。2UVJ-M的动态变化:孕34、36、38周、产后6周UVJ-M分别为(4.13±1.59)mm、(5.92±1.41)mm、(7.77±0.76)mm、(3.04±1.04)mm,随孕周的增加UVJ-M逐渐增大,两两比较,差异有统计学意义(P<0.05)。结论经阴唇三维彩超监测妊娠晚期尿道膀胱颈的移动度对诊断压力性尿失禁有预测价值。
Objective To monitor the size of bladder neck during pregnancy and postpartum, and to evaluate the predictive value of bladder neck mobility during pregnancy on postpartum stress urinary incontinence. Methods A total of 240 pregnant women at Tangshan MCH from June to December 2014 were enrolled in this study. The movement of the bladder neck was monitored by three-dimensional real-time ultrasound of the labia at 34,36,38 weeks and 6 weeks after birth respectively. RESULTS: A total of 1,240 patients were enrolled in the study, and 88 patients with stress urinary incontinence (mean age 25.8 ± 2.12 years) had an average BMI of 34.5 ± 2.01 34 weeks before pregnancy. Non-stress urinary incontinence group of 152 patients, mean age (24.7 ± 1.91) years old, 34 weeks pregnant average BMI was 23.1 ± 2.45. General information between the two groups was comparable (P> 0.05). The prevalence rate of stress urinary incontinence in late pregnancy and urinary bladder neck mobility changes: 1 prevalence rate of SUI during the third trimester of pregnancy and postpartum: 34, 36, 38 weeks pregnant, 6 weeks postpartum SUI prevalence rates were 6.7% 16/240), 17.5% (42/240), 45.8% (110/240) and 7.5% (18/240) respectively. The prevalence of SUI gradually increased with gestational weeks increasing. The dynamic changes of UVJ-M were: 34, 36, 38 weeks pregnant and 6 weeks postpartum. The UVJ-M were 4.13 ± 1.59mm, 5.92 ± 1.41mm, 7.77 ± 0.76mm, 3.04 ± 1.04mm , With the increase of gestational age UVJ-M increased gradually, any pairwise comparison, the difference was statistically significant (P <0.05). Conclusion The three-dimensional ultrasonography to monitor the mobility of the urethral bladder neck in the third trimester of pregnancy has predictive value in the diagnosis of stress urinary incontinence.