| 徐武,柳舜兰,盛军发,吴慧玲,张诗婕,郭雅妮,何韶铮.盆底超声测量提肌板角度评估产后盆腔器官脱垂[J].中国医学影像技术,2022,38(1):112~115 |
| 盆底超声测量提肌板角度评估产后盆腔器官脱垂 |
| Levator plate angle measured with pelvic floor ultrasound for evaluating postpartum pelvic organ prolapse |
| 投稿时间：2021-03-17 修订日期：2021-08-23 |
| DOI：10.13929/j.issn.1003-3289.2022.01.027 |
| 中文关键词: 盆腔器官脱垂 肛提肌 超声检查 |
| 英文关键词:pelvic organ prolapse levator ani muscle ultrasonography |
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| 中文摘要: |
| 目的观察盆底超声测量提肌板角度(LPA)评估产后盆腔器官脱垂(POP)的价值。方法 87名产后女性接受盆底超声检查，根据存在POP与否将其分为POP组(n=49)和正常组(n=38)，分别测量静息状态(LPA静息)、最大缩肛动作(LPA缩肛)及最大瓦尔萨尔瓦动作下(LPA瓦)的LPA，计算最大缩肛动作(△LPA缩肛)和最大瓦尔萨尔瓦动作下LPA变化值(△LPA瓦)；比较2组LPA参数差异，并观察其与POP的相关性。绘制受试者工作特征(ROC)曲线，计算曲线下面积(AUC)，评价各LPA参数诊断POP的效能。结果 POP组LPA瓦小于正常组(U=330.00，P＜0.001)、△LPA瓦大于正常组(t=-4.357，P＜0.001)，而LPA静息、LPA缩肛及△LPA缩肛差异均无统计学意义(P均＞0.05)。POP严重程度与LPA瓦呈中度负相关(r=-0.570，P＜0.001)，与△LPA瓦呈低度正相关(r=0.475，P＜0.001)，而与LPA静息(r=-0.130，P=0.231)、LPA缩肛(r=-0.036，P=0.741)和△LPA缩肛(r=-0.029，P=0.793)均无明显相关。以LPA瓦=2.70°为截断值，其诊断POP的敏感度可达81.63%，特异度达83.67%；以△LPA瓦=21.10°为截断值，其诊断POP的敏感度为67.35%，特异度为81.57%(Z=1.832，P=0.067)。结论采用盆底超声测量LPA可诊断产后POP，以LPA瓦和△LPA瓦的诊断效能最佳。 |
| 英文摘要: |
| Objective To observe the value of levator plate angle (LPA) measured with pelvic floor ultrasound for evaluating postpartum pelvic organ prolapse (POP).Methods Totally 87 postpartum women who underwent pelvic floor ultrasonography were enrolled and divided into POP group (n=49) and normal group (n=38). LPA was measured at resting-state (LPArest), under the maximum pelvic floor contraction (LPAcontraction) and the maximum Valsalva maneuver (LPAVa), and the changes of LPA under the maximum pelvic floor contraction (△LPAcontraction) and the maximum Valsalva maneuver (△LPAVa) were calculated and compared between groups, and the correlations of LPA parameters and POP were observed. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to assess the efficacies of LPA parameters for diagnosing POP.Results LPAVa of POP group was lower than that of normal group (U=330.00, P < 0.001), and △LPAVa of POP group was higher than that of normal group (t=-4.357, P < 0.001), while there was no significant difference of LPArest, LPAcontraction nor △LPAcontraction between groups (all P > 0.05). The severity of POP was moderately negatively correlated with LPAVa (r=-0.570, P < 0.001), lowly positively correlated with △LPAVa (r=0.475, P < 0.001), but not significantly correlated with LPArest (r=-0.130, P=0.231), LPAcontraction (r=-0.036, P=0.741) nor △LPAcontraction (r=-0.029, P=0.793). Taken 2.70° as the cutoff value of LPAVa, the sensitivity for diagnosing POP was 81.63%, and the specificity was 83.67%. Taken 21.10° as the cutoff value of △LPAVa, the sensitivity for diagnosing POP was 67.35%, and specificity was 81.57%. There was no significant difference of diagnostic efficacies between LPAVa and △LPAVa.Conclusion LPA measured with pelvic floor ultrasound could be used to diagnose postpartum POP. LPAVa and △LPAVa had the best efficacies. |
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