TUR术治疗女性膀胱颈梗阻分析  

Analysis of TUR surgery in the treatment of female bladder neck obstruction

作　　者：周鑫[1] 张勇[1] 周永建[1] 严璞[1] 

机构地区：[1]首都医科大学附属北京天坛医院泌尿外科,北京100053

出　　处：《首都医科大学学报》2014年第3期295-297,共3页Journal of Capital Medical University

基　　金：首都医学发展科研基金(2009-2069)~~

摘　　要：目的：探讨经尿道膀胱颈内切开治疗女性膀胱出口梗阻的手术经验。方法女性膀胱颈纤维化致膀胱出口梗阻病例28例,患者年龄52～73岁,患者均有不同程度的下尿路症状。术前评估包括尿动力学检查和膀胱镜检：最大尿流率为4.2～15.2 mL/ s,平均尿流率（7.5±3.1）mL/ s。所有病例均行经尿道膀胱颈内切开（截石位5～7点部位）。术后从尿动力学和临床症状两方面进行评价。结果26例患者拔管后下尿路症状明显改善,2例因长期尿潴留膀胱顺应性差延迟1个月拔管,拔管后排尿明显改善。术后1个月尿流率检查：最大尿流率为13.6～24.8 mL/ s,平均尿流率（14.3±4.1）mL/ s（P 〈0.01）,膀胱残余量为0～30 mL。未出现尿失禁及尿道阴道瘘,全部病例随访6个月～1年。结论经尿道膀胱颈内切开能有效地治疗因女性膀胱出口梗阻引起的下尿路症状。术前应当明确诊断,膀胱镜检及尿动力学评估是必要的。Objective To summarize experience with transurethral incision of the bladder neck（TUIBN） for the treatment of female bladder outlet obstruction （ FBOO）. Methods Bladder outlet obstruction was diagnosed in 28 women 52 to 73 years of age, who presented with the lower urinary tract symptoms. Preoperative investigations included a urodynamic examination and cystoscopy. The maximal flow rate was from 4. 2 mL/ s to 15. 2 mL/ s[mean（7. 5±3. 1） mL/ s]. Transurethral incision of the bladder neck（TUIBN） was performed in all patients. Urodynamic result and clinical symptoms were assessed after operation. Results The lower urinary tract symptoms were resolved or improved in 26 patients. Urodynamic examination revealed an increased maximal flow rate and a decreased postvoid residual urine volume. The maximal flow rate was from 13. 6 mL/ s to 24. 8 mL/ s[mean（14. 3±4. 1） mL/ s] （P〈0. 01） and postvoid residual urine（RU） volme was from 0 to 30 mL at one month postoperation. The follow-up period was from 6 months to 1 year. Conclusion Transurethral incision of the bladder neck（TUIBN） is effective in relieving the lower urinary tract symptoms owing to female bladder outlet obstruction（FBOO）. Urodynamic evaluation is essential in making the correct diagnosis.

关 键 词：女性膀胱出口梗阻 膀胱颈纤维化 尿流动力学 膀胱颈电切术 

分 类 号：R694[医药卫生—泌尿科学]