良性前列腺增生并发膀胱过度活动症的尿动力学诊断  

The urodynamic diagnosis of benign prostatic hyperplasia with coexisting overactive bladder

作　　者：陈园[1] 杜广辉[1] 陈忠[1] 蔡丹[1] 章奇[1] 袁晓奕[1] 曾晓勇[1] 杨为民[1] 叶章群[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院泌尿外科,武汉430030

出　　处：《中华外科杂志》2010年第23期1767-1770,共4页Chinese Journal of Surgery

摘　　要：目的 探讨良性前列腺增生（BPH）合并膀胱过度活动症（OAB）的尿动力学特点,为正确合理的治疗提供参考.方法 回顾性分析2009年1月至2010年5月就诊的235例BPH患者的尿动力学检查资料.患者年龄52～88岁,平均（68±8）岁.根据患者主诉有无OAB症状分为BPH组和BPH合并OAB组;根据尿动力学检查有无逼尿肌过度活动（DO）又将其分为单纯性BPH组、单纯性BPH合并DO组、BPH合并OAB无DO组及BPH合并OAB伴DO组,比较各组年龄、国际前列腺症状评分（IPSS）、前列腺体积、最大尿流率、残余尿量、初感容量、强烈尿感容量、梗阻指数和逼尿肌收缩力情况.结果 最终入选219例患者,年龄56～88岁,平均年龄（66±8）岁,平均前列腺体积（35±24）ml,平均最大尿流率（11±6）ml/s.33.8%（74/219）的患者尿动力学检查出现DO.与BPH组（104例）比较,BPH合并OAB组（115组）年龄更大、IPSS评分更高、前列腺体积更大、初感容量及强烈尿感容量更小、梗阻指数及逼尿肌收缩力减弱比例更高（P＜0.05）.单纯BPH组、BPH合并DO组、BPH合并OAB无DO组及BPH合并OAB伴DO组分别为93例（42.5%）、11例（5.0%）、52例（23.7%）、63例（28.8%）.BPH合并OAB伴DO与BPH合并DO两组比较,前者DO最大逼尿肌压更高、持续DO时间更长.结论 了解BPH合并OAB患者的尿动力学特点对于合理治疗和预测疗效具有重要意义.Abstract：Objective To investigate the urodynamic features in patients of benign prostatic hyperplasia （BPH） with coexisting overactive bladder （OAB）. Methods Clinical data of 235 patients with symptomatic BPH who underwent urodynamic examination during January 2009 to May 2010 were retrospectively analyzeed. Patients were divided into group of pure BPH, BPH with detrusor overacivity （ DO）, BPH with coexisting OAB without DO and BPH with coexisting OAB with DO. The difference of age,International Prostate Symptom Score （IPSS）, transrectus ultrasound （TRUS）-volume, maximum flow rate,residual urine volume, bladder volume of first sensation, bladder volume of strong sensation, bladder outlet obstruction index（BOOI） and the prevalence of decreased detrusor contractility were compared between these groups. The urodynamic characteristics of DO between group of BPH with DO and group of BPH coexisting OAB and DO were analyzed. Results A total of 219 cases were included in the final analysis, with mean age of （66 ± 8） years,mean TRUS-volume was （35 ± 24） ml ,mean maximum flow rate was （11 ± 6） ml/s.Of the 219 patients, 93 patients（42.5%） had pure BPH, 11 patients（5.0%） had BPH with DO,52 patients（23.7% ） had BPH coexisting OAB without DO, 63 patients（28.8% ） had BPH coexisting OAB and DO. Comparing to group of BPH（n = 104）, patients with BPH and OAB（n = 115） were older, had higher IPSS, bigger TRUS-volume, less bladder volume of first sensation and strong sensation, higher BOOI and higher prevalence of decreased detrusor contractility. Comparing to group of BPH with coexisting OAB without DO patients, patients of BPH with coexisting OAB and DO had higher IPSS score（ 19 ± 12 vs 17 ±10）, bigger TRUS-volume[（51 ±33） ml vs （43 ±27） ml], higher BOOI （49 ± 18 vs 37 ± 14）. Comparing to patients pure BPH, patients of BPH with DO had less bladder volume of first sensation and bladder volume of strong sensation [（82±41） ml vs （118 ±35） m

关 键 词：前列腺增生 膀胱 过度活动性 尿动力学 

分 类 号：R686[医药卫生—骨科学]