尿动力学检查在伴膀胱功能障碍的前列腺增生患者治疗中的价值  

The value of urodynamic examination in treating the patient with prostatic hyperplasia accompany with dysfunction of the bladder

作　　者：于惠翀 余大海[1] 王超奇[1] Yu Huichong;Yu Dahai;Wang Chaoqi.(Department of Urology,Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao 028000, Chin)

机构地区：[1]内蒙古民族大学附属医院泌尿外科,通辽市028000

出　　处：《中华泌尿外科杂志》2018年第5期382-385,共4页Chinese Journal of Urology

摘　　要：目的 探讨尿动力学检查在伴膀胱功能障碍的良性前列腺增生（BPH）患者治疗中的应用价值。方法 回顾性分析2015年12月至2016年12月收治的130例单纯性BPH患者的临床资料，除外神经系统病变、中重度糖尿病、中重度高血压病、尿道狭窄、膀胱结石、前列腺癌患者。年龄51-92岁，中位年龄72岁。病史3个月-15年，平均4年。130例均行尿动力学检查，根据检查结果选择治疗方法。结果 本组130例，尿动力学检查结果按膀胱出口梗阻分类：膀胱出口梗阻（BOO）109例，可疑梗阻15例，无梗阻6例。按膀胱功能分类：不稳定性膀胱6例，低顺应性膀胱7例，膀胱收缩乏力15例，无张力性膀胱3例，膀胱功能正常99例。99例膀胱功能正常患者行TURP。3例无张力性膀胱患者中，1例为可疑梗阻，2例为BOO，考虑膀胱功能差，均行膀胱造瘘术。15例逼尿肌收缩乏力患者中，4例为BOO，9例为可疑梗阻，行TURP＋膀胱造瘘术；2例为无梗阻，行保守治疗。6例不稳定性膀胱患者中，2例为无梗阻，行保守治疗；4例为可疑梗阻及BOO，行TURP。7例低顺应性膀胱患者中，2例为无梗阻，行保守治疗；5例为可疑梗阻及BOO，行TURP。本组130例中，108例行TURP，13例行TURP＋膀胱造瘘术，3例行膀胱造瘘术，6例行保守治疗。治疗后3-6个月对患者进行随访，患者症状明显改善，疗效满意。结论 对于BPH合并膀胱功能障碍患者，根据尿动力学检查结果选择正确的治疗方法，可以提高治疗效果。Objective To investigate the value of urodynamic in treating those patients with benign prostatic hyperplasia complicated with bladder dysfunction.Methods 130 patients with benign prostatic hyperplasia were retrospectively reviewed between December 2015 and December 2016. The exclusive criteria included nervous system diseases, moderate to severe diabetes, moderate to severe hypertension, urethral stricture, bladder stones, prostate cancer, etc. The patient＇s age is ranged 51 to 92, mean 72 years old. The previous history of disease ranged from 3 months to 15 years, mean 4 years. All patients accepted the urodynamic examination. Different treatments were considered according to urodynamic studies.Results According to the classification of bladder outlet obstruction, 130 cases were classified as bladder outlet obstruction in 109 cases, bladder suspicious obstruction in 15 cases, no bladder obstruction in 6 cases. According to the classification of bladder function, 130 cases were divided into unstable bladder in 6 cases, low compliance bladder in 7 cases, bladder atony in 15 cases, bladder without tension in 3 cases, normal bladder function in 99 cases. 3 cases without bladder tension, including BOO in 2 cases, suspected BOO in 1 case, were accepted the cystostomy. 15 cases with less detrusor contraction, including BOO in 4 cases, suspected BOO in 9 cases, were accepted the cystostomy and TURP. Conservative treatment was performed in other 2 cases without obstruction. In 6 cases with unstable bladder, 2 cases without obstruction accepted the conservative treatment, 4 cases with suspected BOO accepted the TURP. In 7 patients with low compliance bladder, 2 cases without obstruction accepted the conservative treatment, 5 cases with suspected BOO accepted the TURP. The duration of following up was 3-6 months. The symptoms of the patients in this group improved significantly during following up.Conclusion For patients with benign prostatic hyperplasia complicated with bladder dysfunction, the results of urodynamics c

关 键 词：尿动力学检查 经尿道前列腺电切术 膀胱功能异常 

分 类 号：R697.3[医药卫生—泌尿科学]