超声测量膀胱内前列腺突入程度在判断良性前列腺梗阻中的应用价值

目的 探讨超声测量膀胱内前列腺突入程度(IPP)在判断良性前列腺梗阻(BPO)中的临床应用价值. 方法 良性前列腺增生患者109例,经尿动力学检查诊断无前列腺梗阻25例、可疑梗阻15例、梗阻69例.采用经腹超声测量IPP,比较3组患者的IPP变化,统计学比较分析IPP与尿动力学检测指标的相关性. 结果无梗阻组、可疑梗阻组及梗阻组患者的IPP分别为(2.7±1.2)、(2.9±1.4)和(15.4±6.5)mm,无梗阻、可疑梗阻组与梗阻组间差异有统计学意义(P<0.01).IPP与尿流开始时逼尿肌压、最大尿流率时逼尿肌压、尿流结束时逼尿肌压、最大尿流率及A-G数均相关,r分别为0.628、0.714、0.591、-0.450及0.729(P<0.01).以IPP≥10 mm为BPO判断标准,其敏感性为89.9%、特异性为97.5%、阳性预测值为98.4%、阴性预测值为84.8%,约登指数为0.87. 结论 经腹超声测量IPP操作简便、无痛苦,判断BPO准确,可作为尿动力学诊断BPO的补充方法.

Clinical value of intravesical prostatic protrusion measured by transabdominal ultrasonography in judge-ment of benign prostatic obstruction

Objective To assess the clinical value of intravesical prostatic protrusion (IPP) measured by transabdominal uhrasonography in judgement of benign prostatic obstruction (BPO). Methods According to pressure-flow study, 109 patients with benign prostatic hyperplasia were di-vided into 3 groups (non-obstruction, equivocal obstruction and obstruction). IPP was measured by transabdominal ultrasonography in all patients. The difference of IPP between different groups was studied and the correlation between IPP and the parameters reflecting BPO was analyzed. Results IPP value of the non-obstruction group, equivocal obstruction group and obstruction group was 2.7 ±1.2 mm, 2.9±1.4 mm and 15.4±6.5 mm. There was significant difference in IPP between the non-obstruction group, equivocal obstruction group and obstruction group (P<0.01). IPP was correlated with the parameters including Pdet. Qbeg, Pdet. Qmax, Pdet. Qend, Qmax and A-G number, Spearman's ratio was 0. 628, 0. 714, 0. 591, -0. 450 and 0. 729(P<0.01), respectively. The sensi-tivity and specificity of judging BPO were 89.9% and 97.5% if the cut-off was IPP≥10 mm. Con-clasion IPP measured by transabdominal ultrasonography could be a convenient and accurate method in diagnosis of BPO.