B超测定逼尿肌厚度对膀胱出口梗阻的预测价值

Predictive value of B-ultrasound measurement of detrusor muscle thickness in bladder outlet obstruction

目的探讨B超测定逼尿肌厚度在膀胱出口梗阻(BOO)中的预测价值。方法选取2018年3月至2019年10月于本院接受治疗的56例BOO患者为观察组,另选取同期30例非BOO患者为对照组,两组患者均接受压力-流率测定(PFS)和B超检查。比较两组尿动力学指标、逼尿肌厚度,分析尿动力学指标与逼尿肌厚度的相关性,以PFS诊断结果为金标准,分析B超测定逼尿肌厚度对BOO的预测价值。结果观察组最大逼尿肌压力(Pdet.max)、最大尿流率时膀胱逼尿肌压力(Pdet-Qmax)均高于对照组,残余尿量(PVR)多于对照组,排尿量少于对照组,且逼尿肌厚度大于对照组,差异均有统计学意义(P<0.05)。经Pearson相关性分析,Pdet.max、Pdet-Qmax、PVR与逼尿肌厚度呈正相关(r=0.347、0.321、0.416,P<0.05);排尿量与逼尿肌厚度呈负相关(r=-0.299,P<0.05)。受试者工作特性曲线(ROC)分析显示,当逼尿肌厚度为1.62 mm时,曲线下面积(ACU)为0.709,敏感性为0.761,诊断价值较理想。结论B超测定逼尿肌厚度在BOO中具有较高的预测价值,可为临床BOO的诊断和治疗提供参考。

Objective To explore the predictive value of B-ultrasound measurement of detrusor thickness in bladder outlet obstruction(BOO).Methods A total of 56 BOO patients treated in our hospital from March 2018 to October 2019 were selected as the observation group,another 30non-BOO patients during the same period were selected as the control group,both groups of patients received pressure-flow rate measurement(PFS)and B-ultrasound.The urodynamic indexes and detrusor thickness of the two groups were compared,and the correlation between urodynamic indexes and detrusor thickness was analyzed.Taking the diagnostic result of PFS as the gold standard,the predictive value of B-ultrasound measurement of detrusor thickness in BOO was analyzed.Results The maximum detrusor pressure(Pdet.max),bladder detrusor pressure(Pdet-Qmax)at the maximum urinary flow rate in the observation group were higher than those in the control group,the residual urine volume(PVR)was more than that in the control group,the urine output was less than that in the control group,and the detrusor thickness was greater than that in the control group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that Pdet.max,Pdet-Qmax,and PVR were positively correlated with detrusor thickness(r=0.347,0.321 and 0.416,P<0.05);urine output was negatively correlated with detrusor thickness(r=-0.299,P<0.05).The receiver operating characteristic curve(ROC)analysis showed that when the detrusor thickness was 1.62 mm,the area under the curve(ACU)was 0.709,the sensitivity was 0.761,and the diagnostic value was ideal.Conclusion B-ultrasound measurement of detrusor muscle thickness has high predictive value in BOO,and can provide a reference for the diagnosis and treatment of clinical BOO.