尿道压力测定在评价良性前列腺增生患者膀胱出口梗阻中作用的研究  

Role of urethral pressure profile in assessing bladder outlet obstruction due to benign prostatic hyperplasia

作　　者：方强[1] 宋波[1] 金锡御[1] 樊汝会[1] 

机构地区：[1]第三军医大学西南医院全军泌尿外科研究所,重庆400038

出　　处：《中华泌尿外科杂志》2007年第5期304-307,共4页Chinese Journal of Urology

摘　　要：目的探讨尿道压力测定在评价良性前列腺增生（BPH）患者膀胱出口梗阻中的作用。方法回顾性分析1999年9月至2005年7月因尿频、尿急、排尿困难等下尿路症状就诊的1281例BPH患者的尿动力学检查结果,患者平均年龄67岁。按照国际尿控协会标准,分为无梗阻组168例,可疑梗阻组287例和梗阻组826例。结果梗阻组与无梗阻组患者的平均年龄分别为70岁和57岁,膀胱容量分别为（259±67）和（353±27）ml,剩余尿分别为25．5（0～200）和0．7（0～15）ml,排尿量分别为（157±88）和（288±36）ml,排尿时间分别为（55±23）和（43±7）s。前列腺平台面积分别为（2052±446）和（1055±137）mm×cm H2O,前列腺长分别为（5．0±1．0）和（3．5±0．4）cm,功能曲线长度分别为（6．3±1．1）和（4．8±0．4）cm,膀胱颈压分别为（33．1±12．2）和（15．0±3．6）cm H2O,精阜压分别为（30．7±10．5）和（17．0±3．8）cm H2O,组间比较差异均有统计学意义（P〈0．01）。以压力流率测定结果为标准,受试者工作特征曲线显示,前列腺平台面积≥1440 mm×cm H2O作为判断梗阻标准,敏感性为95．2％,特异性为99．6％。结论前列腺平台面积可以作为判断BPH患者膀胱出口梗阻的有效指标。Objective To study the role of urethral pressure profile （UPP） in assessing bladder outlet obstruction due to benign prostatic hyperplasia. Methods Urodynamic results of 1281 elderly men with lower urinary tract symptoms obtained from September 1999 to July 2005 were retrospectively analyzed. Independent sample t test or Wilcoxon signed-rank test was used to compare the parameters of different groups according to pressure flow study （PFS）. Chi-quare test was used to compare the percentage of UPP types among different groups. ROC curve was used to evaluate the practical value of UPP parameters in diagnosing bladder outlet obstruction. Results According to PFS, patients were divided into three groups： obstructed （826 cases）, equivocal obstructed （287 cases） and unobstructed （168 cases）. The mean age of obstructed and unobstructed were 70 and 57 years, the bladder capacities were （259± 67）ml and （353±27）ml, the residual volumes were 25.5 ml and 0.7 ml, the voided volumes were （ 157 ± 88） ml and （288 ± 36） ml, the voided time were （ 55 ±23） s and （43±7）s,the prostatic plateau areas （PPA） were （2052±446）mm×cm H2O and （1055±137）mm×cm H2O, the prostatic lengths were （5. 0± 1.0）cm and （3. 5±0. 4）cm, the functional profile lengths were （6.3 ±1.1）cm and （4.8± 0.4）cm, the pressures of bladder neck were （33.1 ± 12.2）cm H2O and （ 15.0 ±3. 6） cm H2 O, the pressures of seminal colliculus were （30.7 ±10. 5） cm H2O and （17. 0 ± 3.8） cm H2 O, respectively. There was significant difference between unobstructed and obstructed group in all parameters above. All UPP parameters correlated significantly to the diagnosis of bladder outflow obstruction due to BPH. The largest area under the ROC curve was that of PPA. Conclusions PPA on UPP is useful in assessing the grade of obstruction due to BPH.

关 键 词：尿动力学 良性前列腺增生 膀胱出口梗阻 

分 类 号：R686[医药卫生—骨科学]