【作者】 马斌；

【导师】 宋焱峰；

【作者基本信息】 兰州大学 ， 基础医学·人体解剖与组织胚胎学， 2017， 硕士

【摘要】 第一部分国内外膀胱颈梗阻诊断研究的可视化分析目的分析膀胱颈梗阻诊断的现状,为未来膀胱颈梗阻诊断的研究提供借鉴意义。方法系统检索中国期刊全文数据库、中国生物医学文献数据库、万方数据库、Pub Med和EMBASE.com,纳入所有关于膀胱颈梗阻诊断的研究。用BICOMS2分析软件对关键词进行抽取和整理并生成共现矩阵,同时,分别利用Net Draw和g CLUTO分别绘制网络关系图和进行聚类分析。结果中文膀胱颈梗阻诊断研究数量在期刊、作者、省份分布方面不平衡,主要作者分为6个主要的研究团体,研究人员众多,研究机构纷呈,作者和研究机构间存在一定的联系,研究主题主要有4个;外文膀胱颈梗阻诊断研究数量在期刊、作者、国家分布方面不平衡,主要作者分为3个主要的研究团体,研究主题主要有4个。结论目前国内外从事膀胱颈梗阻诊断研究的研究人员众多,研究机构纷呈,作者之间和研究机构之间的合作有待加强,作者和研究机构间存在一定的联系,研究主题仍需加强。第二部分超声诊断女性膀胱颈梗阻准确性的Meta分析目的采用Meta分析评价超声诊断女性膀胱颈梗阻准确性。方法计算机检索万方数据资源(1997~2017.8)、中国知网(1994~2017.8),中国生物医学文献数据库(1978~2017.8),Pub Med(1969~2017.8)和EMBASE.com等,并辅助其他检索,依据纳入排除标准纳入超声诊断女性膀胱颈梗阻准确性,并用Meta Disc软件进行Meta分析。结果最终纳入8个研究。超声诊断女性膀胱颈梗阻的诊断比值比、敏感度、特异度、阳性似然比、阴性似然比及SROC曲线下面积分别为656.87(95%CI:35.01-12325.72)、0.94(95%CI:0.91,0.96)、0.95(95%CI:0.92-0.97)、17.38(95%CI:2.60-116.28)、0.03(95%CI:0.00-0.47)和0.9935。结论超声具有很高敏感度和特异度,且方便、无创,对女性膀胱颈梗阻的监测有较高的临床价值。第三部分经腹及经阴道超声诊断女性膀胱颈梗阻的临床价值比较目的探讨经腹及经阴道超声检查诊断女性膀胱颈梗阻的敏感性。方法选取甘肃省妇幼保健院在门诊检查的45例女性患者为研究对象,在膀胱适度充盈及排尿两种状态下,分别经腹及经阴道超声扫查膀胱颈部,测量其前、后唇厚度,并测量膀胱残余尿量(bladder residual urine volume,BRUV),根据BRUV进行分组对照,BRUV小于等于12ml为A组,BRUV介于13-49 ml为B组,BRUV大于等于50ml为C组。结果对A组及C组患者,经腹及阴道途经诊断差异无统计学意义(P>0.05);对于B组患者,尿道内口测值敏感性,经阴道超声检查明显大于经腹部检查,差异有统计学意义(P<0.05)。结论在女性膀胱颈梗阻早期,经阴道超声诊断明显优于经腹部超声诊断,能迅速诊断中老年女性膀胱颈梗阻,并能判断其病变程度,为临床诊疗提供依据。更多还原

【Abstract】 Part Ⅰ Visualization analysis the current status the papers ofdiadnosis of bladder neck obstructionObjective To analysis the current status the papers of diadnosis of bladder neck obstruction.It can provide reference for the diagnosis of bladder neck obstruction in the futureMethods Computer retrieved was conducted to search Chinese Biomedical Literature Database,Chinese scientific and technical journals,China Academic Journal database,Pub Med and EMBASE.com.Our study extracted the information of author by BICOMS 2 software,at the same time,the figure of network of author was prepared by Net Draw and g CLUTO.Results There was a serious imbalance in the number of the distribution of authors,journal and province.Which were divided six research teams,although more and more researcher focused on the network meta-analysis,there must be relationships among different researchers and research institutions.at the same time,there were four reaearch topic in Chinese papers.at the same time there was a serious imbalance in the number of the distribution of authors,journal and countries.Which were divided three research teams,meanwhile,there were four reaearch topic in foreign papers.Conclusions Bladder neck obstruction diagnosis research in the world are less number of participating in many of authors,core authors,research institutions and journals are widely distributed.in the future,we should focuse mora research topic.Part Ⅱ Meta-analysis of accuracy of ultrasound for femalebladder neck obstructionObjective To assess the value of ultrasound for female bladder neck obstruction by meta analysis.Methods Computer retrieved was conducted to search Chinese Biomedical Literature Database,Chinese scientific and technical journals,China Academic Journal database,Pub Med and EMBASE.com,the studies of accuracy of ultrasound for female bladder neck obstruction were included,Meta Disc software was used to analysis data.Results Eight studies were included.The results show that the diagnosis odds ratio,sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and SROC curve were 656.87(95%CI: 35.01-12325.72)、0.94(95%CI: 0.91,0.96)、0.95(95%CI: 0.92-0.97)、17.38(95%CI: 2.60-116.28)、0.03(95%CI: 0.00-0.47)and 0.9935,respectively.Conclusions The current evidence showed that ultrasound has high sensitivity and specificity for female bladder neck obstruction,Convenient and non-invasive,which may be benefit for bladder neck obstruction.Part Ⅲ The value of abdominal and transvaginal ultrasound fordiagnosis of female bladder neck obstructionObjective To investigate the sensitivity of the abdominal and transvaginal ultrasound in the diagnosis of female bladder neck obstruction.Methods 45 cases of female patients in the outpatient department of Gansu maternal and child health care hospital as the research object,female prostate disease patients in two states of adequate bladder filling and voiding,respectively transabdominal and transvaginal ultrasound scan to check the bladder neck,measuring the anterior and posterior lip thickness,and measurement of residual urine volume,according to residual urine volume were divided in two groups,the residual urine volume is less than or equal to 12 ml into group A,residual urine volume,13-49 ml for group B,residual urine amount is more than or equal to 50 ml for group C.Results There was no significant difference in the diagnosis of A and C(P>0.05),and the sensitivity of for the patients with B was significantly higher than that of the abdominal examination(P<0.05).Conclusions In the early stage of female bladder neck obstruction,the diagnosis of transvaginal ultrasound is superior to the diagnosis of abdominal ultrasound.It can quickly diagnose the obstruction of urinary tract caused by middle aged and old women,and can judge the extent of the disease.更多还原