良性前列腺增生并急性尿潴留后的逼尿肌功能评估及其临床意义  

Evaluation of detrusor function and its clinical significance in patient with acute urinary retentionsecondary to benign prostatic hyperplasia

作　　者：谢克基[1] 廖土明[2] 李涛[1] 姜粹 汤平[1] 姜少军[1] 曾健文[1] 钟惟德[1] 王良圣[1] 魏鸿蔼[1] 

机构地区：[1]广州医学院附属广州市第一人民医院泌尿外科,510180 [2]广东省佛山市南海中医院

出　　处：《中华泌尿外科杂志》2006年第5期311-313,共3页Chinese Journal of Urology

基　　金：广东省科技计划项目(2KM05603S);广东省医学科学技术研究基金资助项目(WSTJJ2000120842010419640326165)

摘　　要：目的 评估良性前列腺增生（BPH）并急性尿潴留（AUR）后的逼尿肌功能及其临床意义.方法 随机选择38例BPH并AUR患者行膀胱压力-容积和压力-流率测定,分析留置尿管时间、逼尿肌收缩力、逼尿肌无抑制性收缩（DI）、DI幅度、梗阻程度之间的相关性.结果 38例患者中,发生DI者22例（57.9%）,DI幅度3～176（100±41）cm H2O（1 cm H2O=0.098 kPa）;有随意性逼尿肌收缩者32例（84.2%）,明确诊断为膀胱出口梗阻者28例（73.7%）;逼尿肌收缩力与留置尿管时间无相关性（r=-0.024,P＞0.05）,与DI、DI幅度、梗阻程度有相关性（r分别为0.377、0.604、0.473,P分别为＜0.05、0.01、0.01）;DI与梗阻程度无相关性（r=-0.222,P＞0.05）,DI幅度与梗阻程度呈显著性正相关（r=0.494,P＜0.01）.结论 BPH并AUR患者尿动力学检查前无需留置尿管2～3周以上;有DI者的逼尿肌收缩力强于无DI者;膀胱出口梗阻越严重,DI幅度越大,逼尿肌收缩力越强,手术效果越好.Objective To evaluate the detrusor function in patients with acute urinary retention （AUR） due to benign prostatic hyperplasia（BPH） and its clinical significance. Methods A total of 38 patients with AUR secondary to BPH were selected randomly and underwent filling cystometry-volume and pressure-flow studies. The correlations among the lasting time of indwelling catheter, detrusor contraetility,detrusor instability （DI） ,the amplitude of DI and obstruction grades were also analyzed. Results Among the 38 patients who presented with BPH and resultant AUR,DI was found in 22 cases （57.9%） ,the amplitude of DI was （100 ± 41 ） （3 -176） cm H2O; voluntary detrusor contractions were seen in 32 cases （84.2%） ;bladder outlet obstruction was diagnosed definitely in 28 cases （73.7%）. There was no correlation between detrusor contractility and the lasting time of indwelling catheter （ r = - 0. 024, P 〉 0.05 ） , but detrusor contractility was correlated with DI,the amplitude of DI and the grade of bladder outlet obstruction （ r = 0. 377,0. 604 and 0. 473, respectively ; P 〈 0.05,0.01 and 0.01, respectively ）. No correlation between DI and the grade of bladder outlet obstruction was indicated （ r = - 0. 222,P 〉 0.05 ） ,but the correlation between the amplitude of DI and the grade of bladder outlet obstruction was found （ r = 0. 494,P 〈 0.01 ）. Conclusions In patients who present with BPH and resultant AUR,it is not necessary to indwell catheter 2 -3 weeks before urodynamic examination. The contractility of detrusor muscle is stronger in patients with DI than those without DI. The more serious the grade of bladder outlet obstruction and the higher amplitude of DI,the stronger the contractility of detrusor muscle and the better the postoperative results.

关 键 词：尿动力学 良性前列腺增生 膀胱颈梗阻 逼尿肌 急性尿潴留 

分 类 号：R697.3[医药卫生—泌尿科学] R697.32[医药卫生—外科学]