前列腺增生症患者的尿流动力学诊断价值评估  

The evaluation of diagnosis value for urodynamics in patients with benign prostate hypertrophy

作　　者：邓军洪[1] 王良圣[1] 魏鸿蔼[1] 姜粹平[1] 袁衍薇[1] 

机构地区：[1]广州市第一人民医院泌尿外科,广州510180

出　　处：《广州医药》2002年第3期12-14,共3页Guangzhou Medical Journal

摘　　要：目的 :评估尿流动力学检查技术在由前列腺增生症患者所致的下尿路症状中的诊断价值 ,进一步探讨前列腺增生症患者排尿障碍的机制。方法 :采用自制半卧位床 ,应用DantecMenuetV4 11版尿动力仪 ,常规行尿流率、压力 流率测定及尿道测压 ,并同步测定尿道外括约肌肌电图 ,记录Qmax、Pdet Qmax、Popen、Pura、DS (P Q图曲线下降支斜率 )及残余尿量 ;并记录膀胱逼尿肌受损情况、膀胱顺应性和尿道外括约肌协调情况。联合应用A G图、P Q图及DS诊断膀胱出口梗阻(BOO) ,并用LPURR (线性被动尿道阻力因子 )列线图分度 ,结果进行统计处理。所有患者均记录IPSS症状评分值和经直肠B超测定的前列腺体积 ,以利结果分析。结果 :本组患者 388例 ,312例诊断为BOO ,71例可疑 ,5例无BOO。其中伴膀胱低顺应性 12 3例 ,膀胱逼尿肌功能受损 10 8例 ,尿道外括约肌功能失调 15 7例 ,不稳定膀胱 134例。随着BOO程度加重 ,Pdet Qmax、Popen、DS、IPSS积分及前列腺体积呈升高趋势 ,膀胱顺应性、Qmax呈下降趋势。结论 :前列腺增生症患者排尿障碍的机制是排尿过程中机械因素和动力学因素共同作用的结果、尿流动力学检查在其诊断评估中扮演着一个极其重要的角色。BOO程度与Pdet Qmax、Popen、DS、IPSS积分及前列腺体积呈正相关 。Objective: To further research the mechanism of voiding disorder and to evaluate the diagnosis value for urodynamics in patients with benign prostate hypertrophy (BPH) Methods: With self made semi supine bed and Dantec Menuet V4 11 urodynamic device, the full set of urodynamic exam were administrated in 388 patients with BPH, and the extrasphincter urethral myogram was monitored simultaneously in pressure flow studies (PFS) The urodynamic finding such as Qmax?Pdet Qmax? Popen? Pura? DS (descending slope) and post voiding residual (PVR) were recordid, moreover, the situation of bladder detrusor constriction and bladder compliance and urethral sphincter coordination were also recorded The bladder outflow obstruction were diagnosed by combined with A G nomogra?P Q plot and DS; the degree of BOO was quantitated by LPURR (Linear passive urethral resistance relation) The IPSS score and prostate volume were also acquired Results: The diagnosis rate of BOO is 81 7%, concomitantly detrusor muscle impact in 108 cases (28 19%), bladder compliance decreased in 123 cases (32 11%),urethral sphincter dyssynegia in 157 cases (40 99%), and unstable bladder in 134 cases (34 88%) The degree of BOO show a increasing tendency with urodynamic finding such as Pdet Qmax? Popen? DS and IPSS score and prostatic volume respectively, but a decreasing tendency with Qmax and bladder compliance Conclusion: Both the dynamic and mechanical factors are attributed to the voiding disorder in patients with BPH The urodynamic exam play a important role in diagnosis the BOO There is a positive relation among degree of BOO with urodynamic finding such as Pdet Qmax? Popen? DS and IPSS score and Prostatic volume, however, negative relation with Qmax and bladder compliance respectively

关 键 词：前列腺增生症 尿流动力学 诊断价值 评估 

分 类 号：R697.32[医药卫生—泌尿科学]