经直肠三维超声对前列腺增生所致膀胱出口梗阻的评估

Evaluation of Bladder Outlet Obstruction Caused by Benign Prostatic Hyperplasia by Transrectal Three-dimensional Ultrasonography

目的:探讨经直肠三维超声测量前列腺参数和膀胱重量在诊断前列腺增生所致膀胱出口梗阻的临床价值。方法:选取2012年9月-2015年10月本院泌尿外科良性前列腺增生患者中膀胱出口梗阻者30例、非膀胱出口梗阻者30例,比较两组的前列腺总体积(TPV)、移行带体积(TZV)、移行带指数(TZI)、膀胱重量(UEBW)、残余尿量(PVR)、前列腺增生突入膀胱部分(IPP)、IPP与前列腺纵径的比值(IPPR)、前列腺包膜动脉阻力指数(CRI)、最大尿流率(Qmax)及国际前列腺症状评分(IPSS)的差异,IPP与TPV、TZV、IPPS、Qmax相关性分析。结果:膀胱出口梗阻组与非膀胱出口梗阻组的TPV、TZV、TZI、UEBW、PVR、IPP、IPPR、CRI、Qmax及IPSS比较,差异均有统计学意义(P<0.05)。IPP与TPV、TZV均呈正相关(P<0.01),IPP与Qmax呈负相关(P<0.01),IPP与IPSS无明显相关性(P>0.05),UEBW与TPV呈正相关(P<0.01)。结论:经直肠三维超声可以准确测量前列腺参数和膀胱重量,可作为评价膀胱出口梗阻程度的补充手段。

Objective： To investigate the clinical value of transrectal three-dimensional uhrasonography in the measurement of prostate parameters and bladder weight in the diagnosis of bladder outlet obstruction caused by benign prostatic hyperplasia.Method： 30 cases of bladder outlet obstruction and 30 cases of non-bladder outlet obstruction in our hospital from September 2012 to October 2015 were selected, comparison between the two groups in the total prostate volume （ TPV ）, transitional zone volume （ TZV ）, transitional zone index （ TZI ）, bladder weight （ UEBW ）, residual urine volume （ PVR ）, benign prostatic hyperplasia （ IPP ） into the bladder and prostate IPP, the ratio of the vertical diameter （ IPPR ）, prostatic capsular artery resistance index （ CRI ）, the largest the urine flow rate （ Qmax ） and the International Prostate Symptom Score （ IPSS ） of two groups were compared, the correlation of IPP with TPV, TZV, IPPS and Qmax were analyzed.Result： There were significant differences in TPV, TZV, TZI, UEBW, IPP, PVR, IPPR, CRI, Qmax and IPSS in bladder outlet obstruction group and non bladder outlet obstruction group （ P〈0.05 ） .Bladder outlet Obstruction group and non obstruction group of TPV, TZV, TZI, UEBW, PVR, IPP, IPPR, CRI, Qmax and IPSS compared, the differeces were statistically significant （P〈0.05）. IPP was positively correlated with TPV and TZV （ P〈0.01 ）, IPP was negatively correlated with Qmax （ P〈0.01 ）, IPP and IPSS had no significant correlation （ P〉0.05 ）, UEBW and TPV were positively correlated （ P〈0.01 ） . Conclusion： Transrectal three-dimensional ultrasound can accurately measure the prostate parameters and bladder weight, can be used as an evaluation of bladder outlet obstruction degree of additional means.