64例帕金森病伴膀胱尿道功能障碍的临床分析  

Clinical Analysis of Parkinson's Disease with Urinary Bladder Dysfunction:A Report of 64 Cases

作　　者：薛芃[1] 韩志兴[1] 王涛[1] 赵玉千[1] 

机构地区：[1]首都医科大学附属北京天坛医院泌尿外科,北京市100050

出　　处：《中华全科医学》2011年第10期1519-1520,共2页Chinese Journal of General Practice

摘　　要：目的探讨帕金森病伴膀胱尿道功能障碍患者的治疗情况。方法对伴有膀胱尿道功能障碍的64例帕金森病患者进行完善的尿动力学检查,并根据检查结果采取相应的治疗措施。结果逼尿肌反射亢进44例,采用治疗原发病、排尿功能锻炼、抗胆碱能药物治疗有效者28例;6例合并膀胱出口梗阻行经尿道前列腺电切术,2例术后呈明显尿失禁;10例无效者采用外部集尿器。逼尿肌功能受损及失代偿至急、慢性尿潴留20例,其中保留尿管患者14例。经口服α1受体阻滞剂坦索罗辛和/或非那雄胺逐渐恢复自行排尿或排尿症状明显改善者10例,行经尿道前列腺电切术3例,膀胱造瘘术3例,4例采取清洁间歇性自家导尿术。结论结合尿动力学检查对帕金森病伴膀胱尿道功能障碍患者采取相应的治疗措施,以保护肾功能,提高患者生活质量。Objective To investigate the treatment of Parkinson＇s disease with urinary bladder dysfunction.Methods The urodynamic testing was carried out in 64 cases of Parkinson＇s disease with urinary bladder dysfunction,and the appropriate treatments were taken.Results There were 44 cases with detrusor hyperreflexia.In these patients,28 cases were effective to the treatment of primary disease,urinary function exercise,anti-cholinergic drugs;6 cases with bladder outlet obstruction received the transurethral prostate resection;2 cases were with a postoperative urinary incontinence;10 ineffective cases received external urine collection device.There were 20 cases with detrusor dysfunction and its decompensation leaded to acute or chronic urinary retention.14 patients retained catheter.The voluntary micturition was recovered or improved in 10 cases after oralα1-blocker tamsulosin and/or finasteride;10 cases gradually returned to urinate or urinary symptoms improved in,Transurethral resection of prostate（TURP） was performed in 3 cases,cystostomy in 3 cases,clean intermittent self-catheterization in 4 cases.Conclusion Based on the urodynamic testing,the appropriate treatments for Parkinson＇s disease with urinary bladder dysfunction can protect their kidney function and improve their quality of life.

关 键 词：帕金森病 膀胱尿道功能障碍 尿动力学检查 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R691.5[医药卫生—临床医学]