双平面直肠超声对良性前列腺增生下尿路症状患者尿道形态变化的评估研究  

Study of biplane transrectal ultrasound for the assessment of urethral morphological changes in patients with lower urinary tract symptoms of benign prostatic hyperplasia

作　　者：宋涛[1] 高晓军[1] 魏伟[2] 曲虹[1] 贾莉[1] 刘雨洋[1] 车秀媛 SONG Tao;GAO Xiao-jun;WEI Wei(Ultrasound Department,Dalian Friendship Hospital,Dalian 116100,China)

机构地区：[1]大连市友谊医院超声科,116100 [2]大连市友谊医院泌尿外科,116100

出　　处：《中国实用医药》2022年第25期98-101,共4页China Practical Medicine

基　　金：大连市医学科学研究计划项目(项目编号:1811040)。

摘　　要：目的 探讨双平面直肠超声评估良性前列腺增生(BPH)下尿路症状(LUTS)患者的尿道形态变化。方法 104例良性前列腺增生下尿路症状患者,应用双平面直肠超声检测前列腺部尿道实际长度(PU)、近端尿道长度、远端尿道长度、尿道增长值及前列腺尿道角(PUA)、前列腺突入膀胱(IPP)大小和其他形态学参数;应用尿动力学检查仪的压力-流率曲线测得梗阻指数膀胱出口梗阻(BOO)值(AG值),根据尿动力学AG值将患者分为梗阻组(AG值≥40, 56例)与非梗阻组(AG值<40, 48例);梗阻组根据前列腺是否突入膀胱又分为突入组(前列腺突入膀胱, 33例)和非突入组(前列腺未突入膀胱, 23例)。比较梗阻组与非梗阻组及突入组与非突入组的前列腺尿道各项参数,分析前列腺尿道各项参数与AG值相关性。结果 梗阻组前列腺总体积(60.458±15.343)ml、前列腺突入膀胱上下径(1.407±0.503)cm、前列腺尿道角(50.458±14.542)°、尿道增长值(0.707±0.134)cm均大于非梗阻组的(40.376±13.960)ml、(0.000±0.000) cm、(24.045±11.358)°、(0.531±0.120)cm,近端尿道长度(3.015±0.755)cm、尿道实际长度(5.598±0.832)cm均长于非梗阻组的(2.015±0.513)、(4.625±0.745)cm,差异有统计学意义(P<0.05);两组远端尿道长度比较,差异无统计学意义(P>0.05)。前列腺突入膀胱上下径、前列腺尿道角、近端尿道长度、尿道实际长度、尿道增长值与AG值呈正相关(P<0.05)。突入组与非突入组前列腺尿道角、近端尿道长度、远端尿道长度、尿道实际长度、尿道增长值比较,差异无统计学意义(P>0.05)。结论 双平面直肠超声对良性前列腺增生下尿路症状患者前列腺尿道形态显示更清晰,尿道角及尿道增长值可以做为膀胱出口梗阻的预测指标。Objective To discuss the clinical value of biplane transrectal ultrasound for the assessment of urethral morphological changes in patients with lower urinary tract symptoms(LUTS) of benign prostatic hyperplasia(BPH). Methods 104 patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia, and the actual length of prostatic urethra(PU), length of proximal prostatic urethra, length of distal prostatic urethra, urethral increment, prostatic urethral angle and length of intravesical prostatic protrusion(IPP)were measured by biplane transrectal ultrasound and other morphological parameters. The obstruction index bladder outlet obstruction(BOO) value(AG value) was measured by pressure rate curve of urodynamic tester.According to urodynamic AG value, patients were divided into the obstruction group(AG value≥40, 56 cases) and the non-obstruction group(AG value<40, 48 cases). The obstruction group was further divided into the protrusion group(prostate protruding into the bladder, 33 cases) and the non-protrusion group(prostate not protruding into the bladder group, 23 cases) according to whether the prostate protruded into the bladder or not. The parameters of the prostatic urethra were compared between the obstructed group and the non-obstructed group, and protrusion group and non-protrusion group, and the correlation between the parameters of the prostatic urethra and the AG value was analyzed. Results In the obstruction group, the total prostate volume was(60.458±15.343) ml,the upper and lower diameter of intravesical prostatic protrusion was(1.407±0.503) cm, the prostatic urethral angle was(50.458±14.542)°, and the urethral increment was(0.707±0.134) cm, which were greater than(40.376±13.960) ml,(0.000±0.000) cm,(24.045±11.358)°,(0.531±0.120) in the non-obstruction group;the length of proximal prostatic urethra(3.015±0.755) cm and the actual length of prostatic urethra(5.598±0.832) cm were longer than(2.015±0.513) cm and(4.625±0.745) cm in the non-obstruction group;the differen

关 键 词：双平面直肠超声 良性前列腺增生 下尿路症状 尿道形态 

分 类 号：R697.3[医药卫生—泌尿科学]