良性前列腺增生患者膀胱小梁化程度与尿动力学检查结果的相关性研究  

The correlation between bladder trabeculation degrees and urodynamic findings in benign prostatic hyperplasia

作　　者：王东文[1] 双卫兵[1] 张旭[1] 曹晓明[1] 王璟琦[1] 任竹英[1] 吕彦敏[1] 

机构地区：[1]山西医科大学第一医院泌尿外科,太原030001

出　　处：《中华泌尿外科杂志》2004年第7期469-472,共4页Chinese Journal of Urology

摘　　要：目的　分析良性前列腺增生 (BPH)患者由膀胱内窥镜观测到的膀胱小梁化程度和尿动力学检查结果间的相关性。　方法　 35 8例BPH患者 ,按照膀胱镜下膀胱小梁化的严重程度分为 4级 :0级 :无小梁化 ;1级 :轻度到中度小梁化 ;2级 :重度小梁化 ;3级 :重度小梁化伴假性憩室形成。结合相应的最大自由尿流率、膀胱测压最大尿流率、最大尿流时逼尿肌压力 (PQmax)、最大瓦特因子(WFmax)、膀胱顺应性、剩余尿量及国际前列腺症状评分 (IPSS)等相关指标 ,进行方差分析和相关分析检验。　结果　膀胱小梁化程度 :0级 2 1例 ,1级 2 2 8例 ,2级 82例 ,3级 2 7例。随膀胱小梁化程度加重 ,最大自由尿流率呈现显著性降低趋势 ,0级 (11.5 0± 1.13)ml/s ,1级 (10 .2 8± 2 .2 9)ml/s,2级 (9.80± 0 .98)ml/s,3级 (7.36± 1.37)ml/s(F =2 2 .4 3,P <0 .0 0 1) ;剩余尿量显著增多 ,0～ 3级分别为 (5 3.38± 8.4 5 )、(81.5 1± 4 0 .33)、(83.5 6± 7.6 3)、(130 .89± 2 7.4 9)ml(F =2 4 .0 4 ,P <0 .0 0 1) ;PQmax显著增高 ,0～ 3级分别为 (4 0 .31± 2 0 .73)、(5 0 .11± 16 .2 4 )、(6 6 .5 3± 2 3.6 1)、(85 .33± 32 .5 2 )cmH2 O(1cmH2 O =0 .0 98kPa,F =2 2 .6 5 ,P <0 .0 0 1) ;WFmax显著增高 ,0～ 3级分别为 (8.Objective To analyze the relationship between bladder trabeculation degrees and the urodynamic findings in patients with benign prostatic hyperplasia (BPH). Methods A total of 358 patients with BPH were included.Based upon the urethrocystoscopy, the bladder trabeculation degree was divided into 4 grades:Grade 0-no bladder trabeculation;Grade 1-mild to moderate;Grade 2-severe;Grade 3-severe with formation of pseudo-diverticula.We analyzed the relationship between the bladder trabeculation found by fiber urethrocystoscopy and the urodynamic findings such as maximum flow rate (Qmax),P Qmax.Watte factor,compliance and residual urine volume.For statistical analysis AVOVA (analysis of variance) and Spearman correlation were used. Results In the 358 cases,the bladder trabeculation degrees were as follows:Grade 0,21 cases;Grade 1,228 cases;Grade 2,82 cases and Grade 3,27 cases.A significant correlation was found between bladder trabeculation and the urodynamic findings.As the degree of bladder trabeculation increased,Qmax decreased (Grades 0 to 3:11.50±1.13,10.28± 2.29,9.80±0.98,7.36±1.37 ml/s,respectively;F=22.43,P<0.001);the residual urine volume increased (Grades 0 to 3:53.38± 8.45,81.51±40.33,83.56±7.63,130.89±27.49 ml,respectively;F=24.04,P<0.001);(P det.Qmax) increased (Grades 0 to 3:40.31±20.73,50.11±16.24,66.53±23.61,85.33±32.52 cmH 2O,1 cmH 2O=0.098 kPa;F=22.65,P<0.001);Watte factor increased (Grades 0 to 3:8.98±1.14,8.93±198,10.08±2.18,12.07±4.32 W/m 2;F=3.485,P<0.05);while the bladder compliance decreased (Grades 0 to 3:38.51±32.60,30.32±30.62,33.28±27.56,35.56±55.96 ml/cmH 2O).It was also found that the detrusor instability was significantly correlated with grades of trabeculation.As the degree of bladder trabeculation increased, the detrusor instability increased (Grades 0 to 3: 14.3%,13.6%,23.2%,40.7%;r= 0.17). Conclusions There is a significant correlation between the urethrocystoscopic findings and urodynamic investigations.The bladder trabeculation matches well w

关 键 词：前列腺增生 膀胱小梁化 尿动力学 BPH 逼尿肌功能 

分 类 号：R697.32[医药卫生—泌尿科学]