尿动力学检查在卒中后神经源性膀胱合并良性前列腺增生导致排尿困难中的应用  

Application of Urodynamic Examination in Urinary Dysfunction Caused by Post-stroke Neurogenic Bladder Combined with Benign Prostate Hyperplasia

作　　者：涂红坚 李玉梅 TU Hongjian;LI Yumei(Department of Urology,Nanchang People's Hospital,Nanchang 330000,China;不详)

机构地区：[1]南昌市人民医院泌尿外科,江西南昌330000 [2]南昌市人民医院神经内科,江西南昌330000

出　　处：《中国医学创新》2024年第17期28-32,共5页Medical Innovation of China

基　　金：江西卫生健康委科技计划项目(202311260)。

摘　　要：目的:探讨尿动力学检查在卒中后神经源性膀胱(PSNB)合并良性前列腺增生(BPH)导致排尿困难治疗中的应用价值。方法:选取2020年1月—2023年12月在南昌市人民医院治疗的60例PSNB合并BPH导致排尿困难的患者作为研究对象,采用随机数字表法分为对照组(n=30)和观察组(n=30),对照组患者行传统经尿道前列腺切除术(TURP)治疗,观察组患者治疗前行尿动力学检查,根据尿动力学检查参数选择治疗方案(单纯导尿术、膀胱造瘘术、TURP)。比较两组治疗前后的最大尿流率(Qmax)、最大尿流率时的逼尿肌压力(Pdet@Qmax)、膀胱残余尿量(PVR)、每日平均排尿次数、每日单次平均排尿量、生活质量(QOL)评分及国际前列腺症状评分(IPSS)。结果:与治疗前比较,两组治疗后7 d的IPSS、QOL评分均下降,观察组的IPSS、QOL评分均低于对照组,差异均有统计学意义(P<0.05);两组治疗后7 d的Qmax、Pdet@Qmax、每日单次平均排尿量均升高,每日平均排尿次数、PVR均下降,观察组的Qmax、Pdet@Qmax、每日单次平均排尿量均高于对照组,每日平均排尿次数、PVR均低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:采用尿动力学检查对PSNB合并BPH患者治疗方式的选择有指导作用,可增加临床治疗的效果,减少因盲目开展TURP导致的并发症。Objective:To explore the application value of urodynamic examination in the treatment of urinary dysfunction caused by post-stroke neurogenic bladder(PSNB)combined with benign prostatic hyperplasia(BPH).Method:From January 2020 to December 2023,60 patients with PSNB and BPH causing difficulty in urination who were admitted to Nanchang People's Hospital were selected as the study subjects,and were divided into the control group(n=30)and the observation group(n=30)by the method of random number table.The control group were treated with transurethral resection of prostate(TURP),the patients in the observation group were examined urodynamically before treatment,and the treatment plan(simple catheterization,vesicostomy,TURP)was selected according to the parameters of urodynamic examination.Maximum urinary flow rate(Qmax),forced urethral pressure at maximal urinary flow rate(Pdet@Qmax),post-void residual urine(PVR),mean number of urinations per day,mean volume of urine voided in a single sitting per day,quality of life(QOL)score and international prostate symptom score(IPSS)before and after treatment were compared between the two groups.Result:Compared with before treatment,the IPSS and QOL scores of both groups decreased 7 days after treatment,and the IPSS and QOL score of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05);7 days after treatment,Qmax,Pdet@Qmax and average daily urination volume increased,while average daily urination frequency and PVR decreased in both groups,Qmax,Pdet@Qmax and average daily urination volume in observation group were higher than those in control group,while average daily urination frequency and PVR were lower than those in control group,the differences were statistically significant(P<0.05).The incidence of complications after treatment in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Urodynamic examination has a guiding role in the sele

关 键 词：尿动力学检查 卒中后神经源性膀胱 良性前列腺增生 经尿道前列腺切除术 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R694.5[医药卫生—临床医学] R697.3