探讨盆底超声在女性产后膀胱膨出诊断中的应用价值。

选取94例产后膀胱膨出患者为病例组，35例产后无症状经临床及超声检查排除膀胱膨出者为对照组，对2组受检者均行盆底二维及实时三维超声检查，采用t检验比较2组最大Valsalva状态时的膀胱颈移动度（BND）和肛提肌裂孔面积，绘制ROC曲线，评估BND和肛提肌裂孔面积在膀胱膨出中的诊断价值。

病例组的BND、肛提肌裂孔面积分别为（26.2±6.5）mm、（25.2±6.7）cm²，明显大于对照组的（9.9±4.7）mm、（15.6±3.9）cm²，差异均有统计学意义（t=13.56、7.92，P均<0.01）。BND、肛提肌裂孔面积诊断膀胱膨出的临界值分别为16 mm、17.9 cm²，曲线下面积分别为0.982、0.905，其敏感度、特异度分别为98.9%、88.6%，88.3%、80.0%。

最大Valsalva状态时的BND、肛提肌裂孔面积可作为影像学指标用于女性产后膀胱膨出的诊断，且均具有较高的诊断价值。

To evaluate the diagnostic value of pelvic ultrasonography in female patients with postpartum bladder prolapse.

A total of 94 cases of postpartum females with cystocele were enrolled in the study group. And 35 postpartum asymptomatic subjects excluding cystocele by clinical and ultrasound examination were selected as the control group. Transperineal two-dimensional and real-time three-dimensional ultrasound was performed in two groups, and the bladder neck descent (BND) and the area of levator hiatus in Valsalva maneuver were measured, respectively. The BND and the area of levator hiatus were compared between the two groups, and ROC curve were used to assess the value of ultrasound in diagnosis of cystocele.

The BND and the area of levator hiatus in Valsalva maneuver were (26.2±6.5) mm and (25.2±6.7) cm² respectively in the study group, which were significantly higher than those in the control group (9.9±4.7) mm and (15.6±3.9) cm². There were significant differences in BND and area of levator hiatus between the two groups (t=13.56, 7.92, both P<0.05). The cut-off value of the BND and the area of levator hiatus in diagnosis of cystocele were 16 mm and 17.9 cm² in Valsalva maneuver, respectively. The area under the curve were 0.982 and 0.905, while the sensitivity and specificity were 98.9%, 88.6%, 88.3%, 80.0%, respectively.

The BND and the area of levator hiatus can be used as the imaging index to diagnose female postpartum cystocele in Valsalva maneuver with high diagnostic value.