前列腺增生合并糖尿病患者尿动力学检查分析及其临床意义  

Analysis and value of urodynamic changes in patients with benign prostatic hyperplasia complicated with diabetes mellitus

作　　者：高雪松[1] 杨封慧[1] 于春杰[1] 孙涛[1] 

机构地区：[1]海军总医院泌尿外科,北京100048

出　　处：《中华航海医学与高气压医学杂志》2017年第3期209-212,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：全军医药卫生科研项目（CHJI1J017）

摘　　要：目的 分析前列腺增生（benign prostatic hyperplasia,BPH）合并糖尿病（diabetes mellitus,DM）的尿动力学变化特点及诊治意义.方法 选择本院泌尿外科2014年1月至2016年8月收治的120例前列腺患者,根据是否伴有DM分为BPH合并糖尿病60例为观察组,单纯BPH 60例为对照组,对2组的尿动力学测定结果进行分析.结果 观察组和对照组的逼尿肌乏力为46.67％和21.67％,高顺应性膀胱为40.00％和18.33％,逼尿肌功能受损分别为56.67％和33.33％,差异具有统计学意义（x2=18.865,P=0.037;x2=19.458,P=0.043;x2=18.382,P=0.041）.膀胱出口梗阻分别为75.00％和68.33％,逼尿肌不稳定分别为51.67％和41.67％,差异无统计学意义（x2=6.586,P=0.135;x2=4.963,P =0.126）;观察组和对照组的膀胱初尿意容量分别为（242.08±15.46） ml和（146.65±22.34） ml,膀胱最大容量为（306.65±44.52） ml和（226.85±22.73） ml、残余尿量为（166.18 ±23.35） ml和（56.00±12.31）ml,最大尿流时逼尿肌压力（26.46±9.64） cmH2O（1 cmH2O=0.098 kPa）和（61.73±11.75） cmH2O、膀胱顺应性为（47.36±4.68） ml/cmH2O和（23.26±5.37） ml/cmH2O及最大尿流率（Qmax）为（4.12 ±2.12） ml/s和（8.78±2.36） ml/s,比较差异均有统计学意义（t=2.235,P =0.016;t=2.183,P=0.045;t =2.275,P =0.038;t =2.258,P =0.042;t =2.465,P =0.033;t =2.472,P =0.032）.结论 伴有糖尿病的BPH患者,膀胱逼尿肌受损较单纯性BPH患者更明显,对BPH合并DM患者应该尽早施行尿动力学检查,为治疗方法的选择提供依据.Objective To Analyze the urodynamic features in the patients with benign prostatic hyperplasia （BPH） complicated with diabetes mellitus （DM） and its diagnostic value.Methods One hundred and twenty patients with BPH who were hospitalized from January,2014 to August 2016 were recruited as study subjects,of whom 60 patients with BPH complicated with MD were designated as the observation group,and the other 60 patients with simple BPH were designated as the control group.Then,analysis was made on the urodynamic test results in the two groups.Results The scores of detrusor dysfunction for the observation group and the control group were respectively 46.67% and 21.67%,and the percentages of high compliance bladder were respectively 40% and 18.33%,while the scores of detrusor damage for the 2 groups were respectively 56.67% and 33.33%.Statistical significance could be seen when comparisons were made between the 2 groups （x2 =18.865,P =0.037;x2 =19.458,P =0.043;x2 =18.382,P =0.041）.The percentages of urinary bladder outlet obstruction were respectively 75.00% and 48.33%,and the percentages of detrusor instability were respectively 51.67% and 41.67%,also with statistical significance （x2 =5.253,P =0.031;x2 =4.963,P =0.026）.Initial precipitant urination volumes for the observation group and the control group were respectively （242 ＋ 15.46） ml and （146 ＋ 22.34） ml,maximum bladder capacity for the 2 groups were respectively （306 ＋44.52） ml and （226 ＋ 22.73） ml,residual urine volumes were respectively （166.18 ＋ 23.35） and ml （56 ± 12.31） ml,precipitant urination pressures at maximum urinary flow were respectively （26.46 ＋ 9.64） cmil20（1 cmil20 =0.098 kPa） and （61.73 ＋ 11.75） cmH20,the scores of bladder compliance for the 2 group were respectively （47.36 ＋4.68） ml/cmH20 and （23.26 ＋ 5.37） mL/cmH2O,and maximum urinary flow rate （Qmax） for the 2 groups were respectively （4.12 ＋ 2.12） ml/s and （8.78 ＋2.36） mL/s.Statistical significance

关 键 词：前列腺增生 糖尿病 尿动力学 逼尿肌功能 

分 类 号：R587.1[医药卫生—内分泌] R697.3[医药卫生—内科学]