经直肠三维超声测量逼尿肌厚度在诊断膀胱出口梗阻的临床意义  

The clinical significanle of dimensional transrectal ultrasound measurement of detrusor thickness in diagnosing bladder outlet obstruction

作　　者：皮永前[1] 潘永寿[1] 秦蕾[1] 熊思[1] 隆电熙[2] 阮坚[1] 蒋云秀 

机构地区：[1]广西柳州市柳铁中心医院超声科,广西柳州545007 [2]广西柳州市柳铁中心医院泌尿外科,广西柳州545007

出　　处：《医学影像学杂志》2016年第12期2265-2267,共3页Journal of Medical Imaging

基　　金：广西柳州市科学研究与技术开发计划项目(2013J030414);广西医疗卫生自筹经费计划课题(No.Z2011237)

摘　　要：目的探讨经直肠三维超声测量膀胱逼尿肌厚度(detrusor wall thickness,DWT)对前列腺增生所致膀胱出口梗阻(bladder outlet obstruction,BOO)的临床意义。方法将有下尿路症状的良性前列腺增生患者分为膀胱出口梗阻组、非膀胱出口梗阻组和正常对照组,比较组间的DWT与年龄、最大尿流率、残余尿量、及其与国际前列腺症状评分的差异。结果膀胱出口梗阻组DWT(3.5±0.9)mm明显高于非梗阻组(1.8±0.4)mm和正常对照组(1.6±0.3)mm,P<0.01,有统计学意义。逼尿肌厚度与最大尿流率呈负相关(r=-0.71,P<0.01),与残余尿量正相关(r=0.60,P<0.01),与国际前列腺症状评分正相关(r=0.54,P<0.01)。以逼尿肌厚度≥2.9mm为标准诊断BOO的准确率为92.2%(83/90),假阳性率为3.3%(2/60),假阴性率为16.7%(5/30)。结论经直肠三维超声测量DWT可作为预测BOO的重要指征之一。Objective To discuss dimensional transrectal ultrasound measurements of bladder detrusor thickness （DWT） for benign prostatic hyperplasia bladder outlet obstruction （BOO）. Methods The patients with benign prostatic hyperplasia with lower urinary tract symptoms were divided into bladder outlet obstruction group, non bladder outlet obstruction group and normal control group, DWT and age, maximum urinary flow rate, residual urine volume, and international prostate symptom score were compared between the groups. Results Bladder outlet obstruction group DWT （3.5 ± 0.9） mm was significantly higher than non-obstructive group （1.8 ±0.4） mm and normal control group （1.6 ± 0.3 ） mm, P 〈 0.01, with statistically significanle. De- trusor thickness and maximum flow rate were negatively correlated （ r = -0.71, P 〈 0. 01 ）, and residual urine volume was posi- tively correlated （ r =- 0.60, P 〈 0.01 ）, and the International Prostate Symptom scores were positively correlated （ r = 0.54, P 〈 0. 01 ）. In detrusor thickness ≥2.9 mm BOO standard diagnostic accuracy was 92.2% （83/90）, the false positive rate was 3.3 % （2/60）, the false negative rate was 16.7% （5/30）. Conclusion Three-dimensional transrectal ultrasound measurements DWT can be used as an indicator to predict BOO.

关 键 词：膀胱逼尿肌厚度 经直肠三维超声 膀胱出口梗阻 

分 类 号：R694[医药卫生—泌尿科学] R445.1[医药卫生—外科学]