经超声测定逼尿肌厚度在诊断老年女性膀胱出口梗阻中的应用

目的探讨研究经超声测量膀胱逼尿肌厚度在诊断老年女性膀胱出口梗阻中的应用价值。方法收集本院2009年9月至2012年9月伴有下尿路症状的102例60岁以上老年女性患者作为研究对象,将所有患者按压力流速测定结果分为梗阻组与非梗阻组,梗阻组Qmax≤12mL/s,最大尿流率时逼尿肌压力≥25cmH2O,非梗阻组Qmax>12mL/s,最大尿流率时逼尿肌压力<25cmH2O,分析并比较两组之间的年龄、尿动力学参数、膀胱逼尿肌厚度的差异,并计算膀胱逼尿肌厚度≥1.9mm时在无创诊断老年女性膀胱出口梗阻的特异性及敏感性。结果两组患者之间的年龄比较差异无统计学意义(P>0.05);两组最大逼尿肌压力、最大尿流率时逼尿肌压力、Qmax、排尿量、残余尿量及逼尿肌厚度比较差异有统计学意义(P<0.05),当膀胱前壁逼尿肌厚度≥1.9mm时,诊断膀胱出口梗阻的敏感性为39%,特异性为100%。结论经超声测定膀胱前壁逼尿肌厚度在诊断老年女性膀胱出口梗阻具有无创伤,简单、方便的特点,值得在临床推广。

The Application of Detrusor Thickness Measured by Ultrasound in the Diagnosis of the Elderly Female Bladder Outlet Obstruction

Objective To study the ultrasonic measurement of bladder wall thickness in the diagnosis of senile female bladder outlet obstruction in the application.Methods the hospital from 2009.9 -2012.9with lower urinary tract symptoms in 102 patients 60 years of age or older female patients as the object of study,all patients according to the pressure flow rate measuring results into obstruction group and non obstruction group,obstruction group Qmax ≤12mL/s,maximum urinary flow rate when the detrusor pressure≥25cmH2O,non obstruction group Qmax12mL/s,maximum urinary flow rate when the detrusor pressure 25cmH2O,analyzed and compared between the two groups for age,urodynamic parameters,bladder detrusor thickness differences,and calculate the bladder detrusor thickness ≥1.9mm in noninvasive diagnosis of bladder outlet obstruction in elderly women the specificity and sensitivity.Results of the two groups of patients between the ages of no significant differences between the two groups（P 0.05）;maximum detrusor pressure,maximum urinary flow rate when the detrusor pressure,Qmax,urination,residual urine volume and detrusor thickness had significant difference（P0.05）,when the anterior wall of the bladder detrusor thickness ≥1.9mm,the diagnosis of bladder outlet obstruction the sensitivity was 39%,specificity was 100%.Conclusion ultrasound measurements of the anterior wall of the bladder detrusor thickness in the diagnosis of senile female bladder outlet obstruction with no trauma,simple and convenient,it is worthy of clinical.