经超声逼尿肌厚度测定在可疑膀胱出口梗阻患者中的应用  

Ultrasound measurement of detrusor wall thickness in equivocal bladder outlet obstruction

作　　者：李宁[1] 李永智[1] 宫雪[1] 刘屹立[1] 王平[1] 

机构地区：[1]中国医科大学附属第四医院泌尿外科,沈阳110032

出　　处：《中华泌尿外科杂志》2011年第2期112-114,共3页Chinese Journal of Urology

摘　　要：目的分析可疑膀胱出口梗阻患者术前逼尿肌厚度，探讨逼尿肌厚度测定对可疑膀胱出口梗阻患者术后疗效的预测作用。方法对可疑膀胱出口梗阻并行手术治疗的86例患者在行压力流率测定过程中，当膀胱容量为250ml或灌注量为膀胱最大容量的50％时，应用7．5MHz高频线纵超声探头行膀胱前壁逼尿肌厚度测定。术后3个月复查，将患者分为疗效显著组与疗效非显著组，比较2组患者年龄、前列腺体积及逼尿肌厚度。结果疗效显著组（37例）与疗效非显著组（49例）患者年龄及前列腺体积差异无统计学意义（P〉0．05）。逼尿肌厚度差异有统计学意义[（2．5±0．3）和（2．2±0．3）min，P〈0．01]。应用受试者工作特性曲线，当逼尿肌厚度≥2．8mm时，逼尿肌厚度测定作为预测工作特异性和阳性预测值均为100％，而敏感性为19％，阴性预测值为62％。其曲线下面积为0．84±0．04。结论逼尿肌测定预测可疑膀胱出口梗阻患者术后疗效可靠，但仍需要多中心、大样本的试验进一步确定临界值。Objective To estimate the application of ultrasound measurement of detrusor wall thickness （DWT） in the assessment of curative effect after operation. Methods Detrusor thickness was measured by linear ultrasound （7.5 MHz） either at a filling volume of 50% of cystometric capaci ty or at 250 ml filling in 86 patients, who were diagnosed equivocal BOO, during a pressure-flow study. All patients accepted transurethral resection of the prostate. At 3 months post-surgery, the pa- tients were divided into two groups according to curative effect after operation. The volume of the prostate, age and DWT were compared between the two groups. Results There was no difference in either age or volume of the prostate between the two groups. DWT was significantly higher （P〈0. 01） in the more curative effect group （37 cases, DWT 2.5±0.3 mm） compared to the less curative effect group （49 cases, 2.2±0.3 mm）. As a predictor of curative effect, DWT of 2.8 mm or greater had a positive predictive value of 100%, a negative predictive value of 62%, specificity of 100~ and sensitivity of 19%. Receiver operating characteristic analysis （ROC） revealed that DWT had a high predictive value for curative effect post-surgery with an AUC of 0. 84±0. 04. Conclusions In patients with equivocal BOO, ultrasonographically assessed detrusor thickness may have a predictive val ue for curative effect post-surgery. However, this cutoff value needs to be validated in a larger study population.

关 键 词：超声 逼尿肌厚度 可疑膀胱出口梗阻 

分 类 号：R699.5[医药卫生—泌尿科学]