尿动力学检查在BPH患者诊治中的临床意义  

Clinical significance of urodynamic test on patients with benign prostatic hyperplasia

作　　者：吕联辉[1] 颜醒愚[1] 王江涛[1] 孙建国[1] 

机构地区：[1]福建医科大学附属第二医院泌尿外科,福建福州362000

出　　处：《吉林医学》2010年第4期451-453,共3页Jilin Medical Journal

摘　　要：目的:评价尿流动力学检查在良性前列腺增生症患者诊治中的意义。方法:对74例BPH患者治疗前后分别进行残余尿测定、国际前列腺症状评分(IPSS)和尿流动力学检查。结果:74例中有69例存在膀胱出口梗阻,3例可疑梗阻,2例无梗阻。逼尿肌压力正常或增强10例,逼尿肌收缩力减弱或无力8例(3例表现高顺应性膀胱),逼尿肌功能不稳定37例,19例伴有低顺应性膀胱。根据检测结果选择不同方法进行治疗,其中,经尿道前列腺电切(TURP)61例,行耻骨上经膀胱前列腺摘除术6例,Madigan前列腺摘除术2例,膀胱造瘘术3例,保守治疗2例。治疗后3个月复查,取得满意疗效。结论:BPH患者术前尿流动力学检测可以明确膀胱出口有无梗阻,了解逼尿肌顺应性和收缩功能,有助于临床鉴别诊断、估计预后,对选择合理的治疗方案、提高疗效具有重要的临床意义。Objective To evaluate the clinical significance of urodynamics test in the preoperative diagnosis and treatment of benign prostatic hyperplasia（BPH）.Method The urodynamics tests were performed on 74 patients with BPH before and after treatment.Also,the IPSS and post-voiding residual were recorded.Results For 74 patients consisted of 69 cases with bladder outlet obstruction,3 cases of suspected obstruction,2 cases without obstruction.Ten cases of detrusor hyperrefexia,8 cases of detrusor contractility weakened or powerless which including 3 cases of high-performance compliance bladder,37 cases of unstable detrusor function,19 patients with low compliance bladder.According to test results and IPSS,different method treatments were choosed,which included 61 cases of TURP,6 cases of suprapubic prostatectomy,2 cases of Madigan prostatectomy,3 cases of cystostomy surgery,2 cases of conservative treatment.After treatment,all 74 patients got satisfactory results by reexamination at 3rd month.Conclusion The preoperative UDS on patients with HPG can determine the presence of bladder outlet obstruction and the compliance and systolic function of detrusor muscles,would be usefull in differential diagnosis and in evaluating of curative effect,would play an important role in selecting reasonable operation mode and improving curative effects.

关 键 词：前列腺增生 膀胱出口梗阻 尿动力学 

分 类 号：R697.3[医药卫生—泌尿科学]