尿流动力学在良性前列腺增生患者围手术期的应用  

The Application of Urodynamics in the Perioperative Period of Benign Prostate Hyperplasia

作　　者：陈卓[1] 贾国金[1] 陆雪强[1] 谢雪锋[1] 马强[1] 

机构地区：[1]复旦大学附属金山医院泌尿外科,上海200540

出　　处：《实用医学进修杂志》2009年第2期104-107,共4页Journal of Practical Training of Medicine

摘　　要：目的：研究尿流动力学检查在良性前列腺增生（BPH）患者手术前后的临床应用价值。方法：对132例具有手术指征的BPH患者，手术前后进行详细的尿流动力学检查并分析检查结果。结果：132例患者均为中重度的膀胱出口处梗阻（BOO），其中伴不稳定膀胱76例（57．6％），低顺应性膀胱20例（15．2％），不稳定膀胱合并低顺应性膀胱17例（12．9％）。手术后4—6月疗效不满意17例（12．9％），其中术后仍有排尿不畅13例，出现尿失禁4例。其中排尿不畅13例中残余梗阻2例（15．4％），并发膀胱颈挛缩1例（7．7％），逼尿肌功能受损而未能恢复7（53．8％）例，假性排尿困难3例（23．1％）；4例尿失禁中，低顺应性膀胱或不稳定膀胱2例（50％，术前已诊断），两者均有1例（25％），残余梗阻1例（25％）。经再次治疗后，均疗效满意。结论：尿流动力学检查在BPH患者围手术期具有重要的临床应用价值，为BPH术前的诊断、治疗方式的选择、疗效的评价及术后并发症判定提供客观依据。Objective： To research the clinical value of urodynamics in the perioperative period of BPH patients. Methods： 132 cases of BPH patients who should be surgical operation were analysed by detailed urodynamic method in the perioperative period. Results： All the patients were diagnosed with moderately - severely BOO, 76 patients （57. 6% ） had detrusor instability, 20 patients （ 15.2% ） had low compliance bladders, 17 patients （ 12.9% ） had both detrusor instability and low compliance bladders. Forth - six month after operation, re - examination showed unsatisfactory results in 17 patients （ 12.9% ）. Of them, 13 patients still had dysuria, which was due to remnant obstruction in 2 （ 15.4% ） , to complicated bladder neck contracture in 1 （7.7 % ） , to poor recoveryof detru- sorfunctionin7 （53.8%） , and to pseudo-dysuriain3 （23.1%）; the other 4 patients had urinary incontinence, including 2 （ 50% ） with severe detrusor instability or low compliance bladders, 1 （25%）with both detrusor instability and low compliance bladder, 1 （25%） with remnant obstruction. All the patients who hadn ＇t satisfied curative effect in first operation gained satisfied curative effect through treatment once more. Conclusions： The urodynamics test have important clinical applied value in the perioperative period of BPH, it could provide objective proof for preoperative diagnosis of BPH and choosing method of treatment and evaluating of curative effect and judgement of postoperative complications.

关 键 词：良性前列腺增生 尿流动力学 患者 临床应用 

分 类 号：R697.32[医药卫生—泌尿科学]