经直肠三维超声测量膀胱重量诊断膀胱出口梗阻的临床价值

目的：探讨经直肠三维超声测量膀胱重量(UEBW)诊断膀胱出口梗阻(BOO)的临床价值。方法选取2012年9月至2015年10月间我院泌尿外科良性前列腺增生患者中膀胱出口梗阻者30例(梗阻组)和非膀胱出口梗阻者30例(非梗阻组),同时选取健康者30例作为对照组,比较组间的UEBW与年龄、最大尿流率、残余尿量、国际前列腺症状评分的差异。结果梗阻组患者的UEBW为(64.8±15.8) g,非梗阻组为(33.3±9.3) g,对照组为(28.0±4.6) g,梗阻组与非梗阻组、对照组间UEBW比较差异均有显著统计学意义(P<0.01)。UEBW与残余尿量呈正相关(r=0.49,P<0.01),与国际前列腺症状评分呈正相关(P=0.70,P<0.01),与最大尿流率呈弱负相关(r=-0.28,P<0.05),与年龄无相关性(r=0.009,P=0.938)。使用经直肠三维超声测量UEBW对BOO的诊断准确率为90%(81/90),假阳性率和假阴性率分别为8.3%(5/60)、13.3%(4/30)。结论经直肠三维超声测量膀胱重量可作为最简单、最微创的预测膀胱出口梗阻的指标。

Clinical value of transrectal three-dimensional ultrasonography in the diagnosis of bladder outlet obstruction by ultrasound-estimated bladder weight

Objective To evaluate the clinical value of transrectal three-dimensional ultrasonography in the di-agnosis of bladder outlet obstruction (BOO) by ultrasound-estimated bladder weight (UEBW). Methods Thirty pa-tients with benign prostatic hyperplasia and bladder outlet obstruction (obstruction group) and 30 patients without blad-der outlet obstruction (non-obstruction group), who admitted to Department of Urology of our hospital from September 2012 to October 2015, were respectively selected as the research subjects. At the same time, thirty healthy subjects were selected as the control group. The differences of UEBW, age, maximum urinary flow rate, residual urine volume and in-ternational prostate symptom score between the groups were compared. Results UEBW in the bladder outlet obstruc-tion group, non-obstruction group and control group were respectively (64.8±15.8) g, (33.3±9.3) g and (28.0±4.6) g, and there were significant differences between the obstruction group and the non-obstruction group, the control group in UEBW (P<0.01). UEBW was positively correlated with residual urine volume (r=0.49;P<0.01) and international pros-tate symptom score (r=0.70; P<0.01), and weakly negatively correlated with maximum urinary flow rate (r=-0.28, P<0.05). There was no correlation between UEBW and age (r=0.009, P=0.938). The diagnostic accuracy of UEBW for BOO was 90% (81/90) by using three dimensional ultrasonography, and the false positive rate and false negative rate were 8.3% (5/60), 13.3% (4/30), respectively. Conclusion UEBW by transrectal three-dimensional ultrasonography can be used as the simplest, the most minimally invasive indicator for prediction of bladder outlet obstruction.