良性前列腺增生症并发急性尿潴留患者膀胱功能评估  

Evaluation of bladder function in patients with acute urinary retention caused by benign prostatic hyperplasia

作　　者：张悦[1] 罗浩[1] 石英[1] 李安国[1] 李国成[1] 李凯[1] 

机构地区：[1]贵州航天医院泌尿外科,贵州遵义563003

出　　处：《局解手术学杂志》2013年第2期176-177,共2页Journal of Regional Anatomy and Operative Surgery

基　　金：贵州省卫生厅科学技术基金(gzwkj 2011-1-100)

摘　　要：目的评估并发急性尿潴留(AUR)的良性前列腺增生症(BPH)患者逼尿肌功能,预测术后疗效。方法对68例并发AUR的BPH患者术前通过尿动力学检查评估下尿路功能,术后行自由尿流率测定评估疗效。结果 53例完成自由尿流率测定的患者最大尿流率(7.3±2.8)mL/s,平均尿流率(3.5±1.7)mL/s,排尿量(189±94)mL。剩余尿小于50 mL者48例,其余5例平均剩余尿118 mL。压力-流率同步测定结果显示,储尿期膀胱功能容量减小、敏感性增高者58例,57例可见逼尿肌不稳定收缩(83.82%)。高顺应性膀胱、逼尿肌收缩乏力者13例。术后61例排尿通畅,7例再次留置导尿7～15 d拔管,4例可以通畅排尿。3例仍不能自主排尿,其中1例行膀胱造瘘,2例间断清洁导尿。结论对于并发AUR的BPH患者术前通过尿动力学检查准确评估下尿路功能,可以预测术后疗效。Objective To evaluate the function and postoperative effect of bladder in patients with acute urinary retention （ AUR ） caused by benign prostatic hyperplasia （BPH）. Methods The function of lower urinary tract and free flow rate in 68 cases with BPH ＋ AUR were evaluated by urodynamic examination. Results Measurements of free urine flow rate in 53 patients showed that Qmax was （7.3±2.8 ） mL/s, Qave was （ 3.5 ±1. 7 ） mL/s, voiding volume （VV） was （ 189±94 ） mL before operation. Residual urine was less than 50 mL in 48 cases ,5 cases with average residual urine was 118 mL. The results of pressure-tlow showed that the capacity of bladder had reduced and bladder hypersensitivity were increased in 58 cases. Detrusor instability was detected in 57 patients （83.82%）. The bladder of 13 patients were diagnosed with high compliance and abnormality in contractility of detrusor. After operation 61 cases voided well,7 cases were performed indwelling catheter for 7 - 15 d. Then 4 cases voided well while 3 cases can not urinate yet. Cystostomy was performed in 1 of the 3 patients and clean intermittent catheterization was used in other 2 patients. Conclusion Urodynamic study is very useful for the treatment of patients with AUR secondary to BPH.

关 键 词：良性前列腺增生症 急性尿潴留 尿动力学检查 逼尿肌 

分 类 号：R697.32[医药卫生—泌尿科学]