超声逼尿肌厚度测量在膀胱出口梗阻患者诊断中应用价值

Diagnosticvalue of ultrasound detection of detrusor wall thickness in patients with bladder outlet obstruction

目的探究超声检测逼尿肌厚度在膀胱出口梗阻(bladder outlet obstruction, BOO)患者中的诊断价值。方法选取2015年1月至2017年12月冀中能源峰峰集团总医院诊治的90例BOO患者作为研究对象(观察组)。另选取同期在冀中能源峰峰集团总医院治疗的90例非BOO者作为对照组,对比两组临床特征以及尿动力学参数;采用超声检测膀胱前壁逼尿肌厚度(DWT);Pearson检验DWT与尿动力参数的相关性,采用受试者工作特征(ROC)评估DWT对BOO的诊断价值,分析DWT诊断BOO的临界值、灵敏度、特异度。结果 BOO组最大膀胱灌注量、排尿量、排尿效率、Qmax均低于非BOO组,残余尿量、PdetQmax、Pdetmax均高于非BOO组,差异均具有统计学意义(P<0.05)。BOO组患者DWT高于非BOO组患者,差异均具有统计学意义(P<0.05)。Pearson相关性分析显示,DWT与PVR、PdetQmax、Pdetmax呈显著性正相关,与最大膀胱灌注量、排尿量、Qmax差异均具有统计学意义(P<0.05)ROC曲线分析显示,DWT对BOO诊断AUC为0.882(95%CI=0.864~0.953,P<0.05),临界值为1.74,此时敏感性为83.02%,特异性为89.62%。结论超声检测逼尿肌厚度在BOO患者诊断中具有较高的敏感性和特异性,可为BOO的诊断、治疗提供一定的参考。

Objective To explore the diagnostic value of ultrasound detection of detrusor wall thickness in patients with bladder outlet obstruction(BOO). Methods 90 cases of BOO patients treated in Jizhong Energy Fengfeng Group General Hospital were selected as the research subjects, and 90 non-BOO patients treated in the same hospital at the same time were selected as the control group. The clinical features and urodynamic parameters of the two groups were compared. The detrusor wall thickness(DWT) in the anterior wall of bladder was measured by ultrasound. The correlation between DWT and urodynamic parameters was examined by Pearson. Receiver operating characteristic(ROC) was used to evaluate the diagnostic value of DWT for BOO. The critical value, sensitivity and specificity of DWT in diagnosing BOO were analyzed. Results The maximal volume of bladder perfusion, voiding volume, voiding efficiency and Qmax of BOO group were all lower than those of non-BOO group, while residual urine volume, PdetQmax and Pdetmax were all higher than those of non-BOO group(P<0.05). The DWT of the BOO group was higher than that of the non-BOO group(P<0.05). Pearson correlation analysis showed that DWT was positively correlated with PVR, PdetQmax and Pdetmax, and was negatively correlated with maximum bladder perfusion, voiding volume and Qmax(P<0.05). ROC curve analysis showed that the AUC of DWT for the diagnosis of BOO was 0.882(95%CI=0.864~0.953, P<0.05), the critical value was 1.74, the sensitivity was 83.02%, the specificity was 89.62%. Conclusions Ultrasound detection of detrusor wall thickness is highly sensitive and specific in the diagnosis of BOO. It can provide a certain reference for the diagnosis and treatment of BOO.