经会阴盆底超声参数联合腹直肌分离度在盆底功能障碍性疾病中的诊断价值OA
Diagnostic Value of Transperineal Pelvic Floor Ultrasound Parameters Combined with Rectus Abdominis Muscle Separation in Pelvic Floor Dysfunction Diseases
目的:评估经会阴盆底超声参数联合腹直肌分离度在盆底功能障碍性疾病(PFD)中的诊断价值.方法:选择2023年1月—2024年1月在宜昌市中心人民医院分娩并于产后42天进行产后复查的212例产妇作为研究对象,按照是否发生PFD分为PFD组(n=98)和非PFD组(n=114).比较两组静息状态和最大Valsava动作时经会阴盆底超声参数和腹直肌分离度的差异性,采用多因素Logistic回归分析发生PFD的影响因素.绘制受试者工作特征(ROC)曲线分析经会阴盆底超声参数联合腹直肌分离度在PFD中的诊断效能.结果:多因素Logistic回归分析显示,最大Valsava动作时肛提肌裂孔面积(LHA)、膀胱颈移动度(BND)、尿道旋转角(URA)、尿道内口漏斗形成率、腹直肌分离度是产妇产后发生PFD的影响因素(均P＜0.05).ROC曲线显示,最大Valsava动作时LHA、BND、URA、尿道内口漏斗形成率及腹直肌分离度单独诊断PFD的灵敏度分别为 80.36％、60.46％、88.42％、75.68％和 67.81％,特异度分别为 45.37％、93.82％、55.37％、49.37％和61.93％,AUC分别为0.673、0.832、0.795、0.618和0.736.经会阴盆底超声参数联合腹直肌分离度在PFD中诊断灵敏度为80.56％,特异度为96.05％,AUC为0.927.结论:经会阴盆底超声参数与腹直肌分离度联合能够显著提升PFD的诊断效能,相较于单一参数评估,该联合诊断方法展现出更优越的临床诊断效能.
Objective:To evaluate the diagnostic value of transperineal pelvic floor ultrasound parameters combined with rectus abdominis diastasis in pelvic floor dysfunction diseases(PFD).Methods:A total of 212 postpartum women who gave birth at Yichang Central People's Hospital from January 2023 to January 2024 and underwent postpartum follow-up 42 days after delivery were selected as the study subjects.They were divided into PFD group(n=98)and non-PFD group(n=114)according to whether PFD occurred.The differences in transperineal pelvic floor ultrasound parameters and rectus abdominis muscle separation between two groups at rest and during maximum Valsalva maneuver were compared.Multivariate Logistic regression analysis was used to identify risk factors for PFD.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of transperineal pelvic floor ultrasound parameters combined with rectus abdominis muscle separation in PFD.Results:Multivariate Logistic regression analysis showed that levator ani hiatus area(LHA),bladder neck descent(BND),urethral rotation angle(URA),funneling rate of the internal urethral orifice during the maximum Valsava maneuver,and the degree of rectus abdominis separation were the influencing factors for the occurrence of PFD in postpartum parturients(all P＜0.05).The ROC curve showed that the sensitivity of LHA,BND,URA,and the funneling rate of the internal urethral orifice during the maximum Valsalva maneuver and the degree of rectus abdominis separation in diagnosing PFD alone were 80.36％,60.46％,88.42％,75.68％and 67.81％respectively,and the specificity were 45.37％,93.82％,55.37％,49.37％and 61.93％respectively,with AUCs of 0.673,0.832,0.795,0.618 and 0.736 respectively.The diagnostic sensitivity of pelvic floor ultrasound parameters combined with rectus abdominis muscle separation in PFD was 80.56％,specificity was 96.05％,and AUC was 0.927.Conclusion:The combination of transperineal pelvic floor ultrasound parameters and rectus abdominis diastasis can significantly enhance the diagnostic efficiency of PFD,exhibiting superior clinical diagnostic performance compared to single-parameter evaluation.
杨丹;李琼兰;向小庆
三峡大学第一临床医学院[宜昌市中心人民医院]超声科,湖北宜昌 443003三峡大学第一临床医学院[宜昌市中心人民医院]超声科,湖北宜昌 443003三峡大学第一临床医学院[宜昌市中心人民医院]超声科,湖北宜昌 443003
医药卫生
盆底功能障碍性疾病经会阴盆底超声参数腹直肌分离度诊断效能
pelvic floor dysfunction(PFD)transperineal pelvic floor ultrasound parametersdegree of rectus abdominis diastasisdiagnostic performance
《巴楚医学》 2026 (1)
57-63,7
湖北省教育厅科学研究计划青年人才项目(Q20231202)
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