Ouslander J G, Simmons S, Tuico E, Nigam J G, Fingold S, Bates-Jensen B, Schnelle J F
UCLA Borun Center for Gerontological Research.
J Am Geriatr Soc. 1994 Nov;42(11):1189-92. doi: 10.1111/j.1532-5415.1994.tb06987.x.
To determine the accuracy of a portable ultrasound device for the assessment of post-void residual (PVR) volume among incontinent nursing home (NH) residents.
Prospective, clinical series.
Seven community-based nursing homes.
Two hundred one consecutively assessed incontinent NH residents who were participating in a larger clinical trial.
PVR volumes measured by trained research associates using a portable ultrasound device and by in-and-out catheterization were compared. The accuracy of the ultrasound was calculated using the volume obtained by catheterization as the gold standard.
The ultrasound demonstrated excellent test-retest and interrater reliability. For low PVRs, the device was highly sensitive (.90) for PVR < 50 mL and .95 for PVR < 100 mL) and moderately specific (.71 for PVR < 50 mL and .63 for PVR < 100 mL). For PVRs of more than 200 mL (n = 26), the ultrasound had a sensitivity of .69 and a specificity of .99.
The portable ultrasound we used was reliable and reasonably accurate for assessing PVR in a representative sample of incontinent NH residents. Because the sensitivity for clinically significant urinary retention (PVR > 200 mL) was only .69, repeated measurements may be necessary to exclude high PVR in individual NH residents. Recent changes in ultrasound design should improve its ease of use and accuracy. Although measuring PVR by ultrasound is much easier and more comfortable than catheterization for both NH residents and staff, the cost of the device may be a barrier to its widespread use in the NH setting.
确定一种便携式超声设备评估失禁养老院居民膀胱残余尿量（PVR）的准确性。
前瞻性临床系列研究。
七家社区养老院。
连续评估的201名参与一项更大规模临床试验的失禁养老院居民。
比较由经过培训的研究人员使用便携式超声设备测量的PVR体积和通过进出式导尿术测量的PVR体积。以导尿术获得的体积作为金标准计算超声的准确性。
超声显示出极好的重测信度和评分者间信度。对于低PVR，该设备对PVR<50 mL的敏感度很高（0.90），对PVR<100 mL的敏感度为0.95，特异性中等（PVR<50 mL时为0.71，PVR<100 mL时为0.63）。对于PVR超过200 mL（n = 26）的情况，超声的敏感度为0.69，特异性为0.99。
我们使用的便携式超声在评估失禁养老院居民的代表性样本中的PVR时可靠且相当准确。由于对临床上显著的尿潴留（PVR>200 mL）的敏感度仅为0.69，可能需要重复测量以排除个别养老院居民的高PVR情况。超声设计的近期改进应会提高其易用性和准确性。虽然对于养老院居民和工作人员而言，通过超声测量PVR比导尿术更容易且更舒适，但该设备的成本可能是其在养老院环境中广泛使用的一个障碍。
