女性膀胱颈硬化症手术前后尿动力学对照观察  

Transurethral resection of bladder neck for female bladder neck sclerosis： a prospective urodynamics study

作　　者：谢平[1] 张旭[1] 盛畅[1] 沈旭华[1] 付强[1] 杨震宇[1] 瞿庆华[1] 黄莺[1] 

机构地区：[1]上海市浦东新区人民医院泌尿外科,201200

出　　处：《中华医学杂志》2011年第46期3281-3283,共3页National Medical Journal of China

基　　金：上海市浦东新区卫生局卫生科技项目（PW2007A-21）

摘　　要：目的 通过对女性膀胱颈硬化症患者手术前后尿动力学观察,期望发现影响手术疗效的原因.方法 30例女性膀胱颈硬化症患者接受经尿道膀胱颈切开术治疗,每例患者均进行6次尿动力学检查,即术前、术后l、2、3、6个月、1年.结果 手术治疗有效27例,无效3例.治疗有效患者的尿动力学参数最大尿流率增大、平均尿流率增大、残余尿量减少、最大逼尿肌压降低（P＜0.05）.无效患者的尿动力学参数最大尿流率、平均尿流率、残余尿量、最大逼尿肌收缩压与术前差异无统计学意义（P＞0.05）.结论 经尿道膀胱颈切开术是治疗女性膀胱颈硬化症的有效方法,术后仍有排尿梗阻症状患者,虽然手术解决了解剖性梗阻,但此类患者可能合并有功能性梗阻,需进一步行影像尿动力学检查证实.Objective To explore the probable unsuccessful reasons for transurethral resection of bladder neck（TUR-BN）of female bladder neck sclerosis.Methods Thirty eligible cases received urodynamic inspections at pre-operation,post-operation of months 1,2,3 and 6 and year 1.Results TURBN was effective in 27 patients（90%）,but ineffective in 3（10%）.Among the effective cases,the urodynamic parameters of Qmax and Qave increased（P 〈 0.05）while the residual urine volume and maximum pressure of detrusor contraction decreased（P 〈 0.05）.The above four parameters showed no difference in those ineffective cases（P 〉 0.05）.Conclusion TUR-BN is an effective therapy for female bladder neck sclerosis.Those ineffective cases are probably caused by functional obstruction.Further urodynamic imaging studies may help to confirm the causes.

关 键 词：膀胱颈梗阻 女性 尿流动力学 经尿道电切 

分 类 号：R699[医药卫生—泌尿科学]