尿动力学检测在糖尿病患者良性前列腺增生手术评估中的意义  

Significance of operation evaluation on urodynamic detection in BPH patients with diabetic

作　　者：王声兴[1] 欧善际[1] 梁培育[1] 许海波[1] 颜毅[1] 何书明[1] 李浩勇[1] 韩一南[1] 吴卫红[1] 

机构地区：[1]海南医学院附属医院泌尿外科,海南海口570102

出　　处：《中国现代医学杂志》2012年第17期95-97,共3页China Journal of Modern Medicine

摘　　要：目的探讨尿动力学检测在糖尿病患者良性前列腺增生(BPH)手术评估中的意义。方法对180例BPH伴糖尿病患者进行尿动力学检测,将逼尿肌收缩强度分为6级:极弱(VW)、弱减(W-)、弱加(W+)、正常减(N-)、正常加(N+)和强烈(ST),把相应的患者分为6组,除了逼尿肌收缩极弱组保守治疗外,其余均行经尿道前列腺切除术(TURP)。结果 180例患者存在不同程度的膀胱出口梗阻(BOO)。124例患者表现为逼尿肌收缩力降低,21例术后出现排尿困难,其中13例经药物和针灸治疗后好转,7例治疗无效,因残余尿量增多而留置尿管。17例术后尿失禁,经药物和针灸治疗后好转,该类患者最大逼尿肌压均大于最大尿道闭合压。结论良性前列腺增生合并糖尿病患者应通过尿动力学检查明确逼尿肌功能状态损害程度,以准确选择手术时机。逼尿肌收缩力为极弱患者,不宜行TURP,建议保守治疗,溴吡斯的明和巴氯芬等药物治疗TURP术后排尿困难效果良好。【Objective】 To assess the significance of operation evaluation on urodynamic detection in BPH patients with diabetic.【Methods】 180 BPH patients with diabetic were carryed out urodynamic detection,etrusor muscle intensity were divided into six grade,for very weak,weak（-）,weak（＋）,normal（-）,normal（＋） and intensity,dividing all patients into six groups,all patients were carried out TURP in addition to the patients that muscle intensity is very weak.【Results】 180 patients show invariably degree BOO,124 cases show detrusor muscle contractility is decrease,21 cases show dysuria,cujus 13 cases get better in acupuncture therapy and pharmacotherapy,7 cases detain urinary catheter with residual urine volume in treatment futility.17 cases show urinary incontinence in postoperation,but get better in acupuncture therapy and pharmacotherapy,this kind patients show maximum detrusor pressure greater than maximal urethral closure pressure.【Conclusions】 BPH patients with diabetic were carried out urodynamic detection to ascertain impairment degree for detrusor muscle functional status,for we accurately choose operation occasion.The patients detrusor muscle myotility is very weak were not carried out TURP,advising expectant treatment.Pyridostigmine Bromide and Baclofen treat dysuria postoperation of TURP.

关 键 词：良性前列腺增生 糖尿病 尿动力学检测 逼尿肌收缩力 

分 类 号：R697.32[医药卫生—泌尿科学]