基于经会阴盆底超声参数及阴道三维超声参数的盆腔器官脱垂合并隐匿性压力性尿失禁预测模型构建及验证

doi:10.3969/j.issn.1671-7171.2026.02.005

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摘要 【目的】 探讨基于经会阴盆底超声参数及阴道三维超声参数的盆腔器官脱垂合并隐匿性压力性尿失禁预测模型构建及验证。【方法】 选取2020年1月至2025年10月在本院诊治的136例盆腔器官脱垂患者,依据80/20定律随机分为训练集(n=106)和验证集(n=30)。训练集106例患者根据是否合并隐匿性压力性尿失禁分为合并组(n=58)和非合并组(n=48)。比较两组经会阴盆底超声参数[静息期:尿道倾斜角(R-UI)、膀胱尿道后角(R-RVA);张力期:尿道倾斜角(V-UI)、膀胱尿道后角(V-RVA)、尿道旋转角(UR)]、阴道三维超声参数[静息期:肛提肌裂孔面积(R-ALH);张力期:肛提肌裂孔面积(V-ALH)、膀胱颈移动度(BND)、漏斗形尿道内口],筛查盆腔器官脱垂合并隐匿性压力性尿失禁发生的影响因素。构建并验证基于经会阴盆底超声参数及阴道三维超声参数的盆腔器官脱垂合并隐匿性压力性尿失禁预测模型。【结果】 合并组患者R-UI、V-RVA、UR、BND、V-ALH、漏斗形尿道内口发生率高于非合并组(P<0.05)。两组患者R-RVA、V-UI比较,差异无统计学意义(P>0.05)。R-UI、V-RVA、UR、BND、V-ALH、漏斗形尿道内口是盆腔器官脱垂合并隐匿性压力性尿失禁发生的影响因素(P<0.05)。训练集列线图模型预测盆腔器官脱垂合并隐匿性压力性尿失禁的灵敏度为0.781,特异度为0.799,曲线下面积为0.819。验证集列线图模型预测盆腔器官脱垂合并隐匿性压力性尿失禁的灵敏度为0.776,特异度为0.791,曲线下面积为0.805。【结论】 基于经会阴盆底超声参数及阴道三维超声参数构建的盆腔器官脱垂合并隐匿性压力性尿失禁预测模型,辅助预测盆腔器官脱垂合并隐匿性压力性尿失禁的效能良好。

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	杨佳怡
	王珏

关键词 ：子宫脱垂, 尿失禁,压力性, 超声检查, 阴道

Abstract：【Objective】 To investigate the construction and validation of a predictive model for pelvic organ prolapse (POP) combined with occult stress urinary incontinence (OSUI) based on transperineal pelvic floor ultrasound parameters and three-dimensional vaginal ultrasound parameters. 【Methods】 A total of 136 patients with pelvic organ prolapse diagnosed and treated in our hospital from January 2020 to October 2025 were selected. According to the 80/20 rule, they were randomly divided into a training set (n=106) and a validation set (n=30). The 106 patients in the training set were further divided into a combined group (n=58, with OSUI) and a non-combined group (n=48, without OSUI) based on the presence or absence of occult stress urinary incontinence. Transperineal pelvic floor ultrasound parameters [at rest: urethral inclination angle (R-UI), bladder-urethral posterior angle (R-RVA); under Valsalva maneuver: urethral inclination angle (V-UI), bladder-urethral posterior angle (V-RVA), urethral rotation angle (UR)] and three-dimensional vaginal ultrasound parameters [at rest: levator ani hiatus area (R-ALH); under Valsalva maneuver: levator ani hiatus area (V-ALH), bladder neck descent (BND), and funneling of the internal urethral orifice] were compared between the two groups. Risk factors for the occurrence of POP combined with OSUI were screened. A predictive model for POP combined with OSUI based on transperineal pelvic floor ultrasound parameters and three-dimensional vaginal ultrasound parameters was constructed and validated.【Results】 R-UI, V-RVA, UR, BND, V-ALH, and the incidence of funneling of the internal urethral orifice in the combined group were higher than those in the non-combined group (P<0.05). No statistically significant differences were found in R-RVA and V-UI between the two groups (P>0.05). R-UI, V-RVA, UR, BND, V-ALH, and funneling of the internal urethral orifice were identified as influencing factors for the occurrence of POP combined with OSUI (P<0.05). In the training set, the nomogram model predicted POP combined with OSUI with a sensitivity of 0.781, specificity of 0.799, and area under the curve (AUC) of 0.819. In the validation set, the nomogram model predicted POP combined with OSUI with a sensitivity of 0.776, specificity of 0.791, and AUC of 0.805. 【Conclusion】 The predictive model for POP combined with OSUI constructed based on transperineal pelvic floor ultrasound parameters and three-dimensional vaginal ultrasound parameters demonstrates good performance in assisting the prediction of POP combined with OSUI.

Key words： Uterine Prolapse Urinary Incontinence, Stress Ultrasonography Vagina

收稿日期: 2025-12-14

中图分类号:

R694.54

通讯作者: ^*E-mail:wangjue_wendy@sina.com

引用本文:

杨佳怡, 王珏. 基于经会阴盆底超声参数及阴道三维超声参数的盆腔器官脱垂合并隐匿性压力性尿失禁预测模型构建及验证[J]. 医学临床研究, 2026, 43(2): 193-197.
YANG Jiayi, WANG Jue. Construction and Validation of a Predictive Model for Pelvic Organ Prolapse Combined with Occult Stress Urinary Incontinence Based on Transperineal Pelvic Floor Ultrasound Parameters and Three-Dimensional Vaginal Ultrasound Parameters. JOURNAL OF CLINICAL RESEARCH, 2026, 43(2): 193-197.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.02.005 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I2/193

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