内科

目的探究经会阴盆底动态三维超声（3DUS）测定的肛提肌裂孔面积（LHA）对盆腔器官脱垂（POP）的诊断价值。方法选取42例POP患者（POP组）和42例无POP的健康女性（非POP组）作为研究对象。比较两组经会阴盆底动态3DUS在最大Valsalva动作状态下测定的LHA，应用受试者工作特征（ROC）曲线评估经会阴盆底动态3DUS测定的LHA对POP的诊断价值。结果 POP组经会阴盆底动态3DUS在最大Valsalva动作状态下测定的LHA大于非POP组（P<0.05），其诊断POP的ROC曲线下面积为0.920（95%CI：0.858～0.982，P<0.001），最佳截断值为17.515 cm2，特异度为0.833，灵敏度为0.881，约登指数为0.714。结论经会阴盆底动态3DUS在最大Valsalva动作状态下测定的LHA对于POP具有良好的诊断价值，诊断的灵敏度、特异度较高。

【Abstract】 Objective To investigate the value of levator hiatus area (LHA) measured by transperineal pelvic floor dynamic three-dimensional ultrasound (3DUS) in the diagnosis of pelvic organ prolapse (POP). Methods A total of 42 POP patients (POP group) and 42 healthy women without POP (non-POP group) were enrolled as study subjects. The LHA measured by transperineal pelvic floor dynamic 3DUS on the maximum Valsalva maneuver was compared between the two groups, and the receiver operating characteristic (ROC) curve was used to evaluate the value of LHA measured by transperineal pelvic floor dynamic 3DUS in the diagnosis of POP. Results LHA on the maximum Valsalva maneuver, measured by transperineal pelvic floor dynamic 3DUS, was larger in the POP group than in the non-POP group (P<0.05), and its area under the ROC curve in the diagnosis of POP was 0.920 (95% CI: 0.858-0.982, P<0.001), with the optimal cut-off value, specificity, sensitivity, and Youden index of 17.515 cm2, 0.833, 0.881, 0.714,respectively. Conclusion LHA measured by transperineal pelvic floor dynamic 3DUS on the maximum Valsalva maneuver has a good diagnostic value for POP, and the sensitivity and specificity of the diagnosis are high.