压力-流率测定在诊断老年男性排尿困难中的意义

The diagnostic value of pressure-flow study in elderly male patients with dysuresia

目的 探讨压力 流率测定在老年男性排尿困难诊断中的意义。 方法 老年男性排尿困难伴前列腺增大者 12 5例 ,年龄 5 6～ 83岁 ,平均 6 8岁 ,均行尿动力学全项检查 ,对成功排尿并获得满意尿流率曲线者行压力 流率测定 ,结果分为膀胱出口梗阻 (BOO)、可疑梗阻、无梗阻 3类 ,并将逼尿肌收缩功能分为很弱、弱、正常、强烈 4级。 结果 12 5例患者中 87例获满意压力 流率测定结果 ,其中BOO 39例 ,可疑梗阻 18例 ,无梗阻 30例。BOO组、可疑梗阻组和无梗阻组的最大尿流率逼尿肌压分别为 (99.2± 34.3)cmH2 O(1cmH2 O =0 .0 98kPa)、(4 6 .9± 9.9)cmH2 O和 (30 .8± 10 .0 )cmH2 O ,膀胱开口压分别为 (99.4± 39.6 )cmH2 O、(4 3.7± 9.9)cmH2 O和 (2 9.9± 9.7)cmH2 O ,排尿期最小逼尿肌压分别为 (6 1.3± 2 7.5 )cmH2 O、(33.9± 14 .1)cmH2 O和 (2 2 .1± 12 .5 )cmH2 O ,最大逼尿肌压分别为 (113.0± 4 2 .1)cmH2 O、(5 5 .8± 14 .9)cmH2 O和 (38.4± 11.3)cmH2 O ,BOO组与无BOO组和可疑BOO组差异均有极显著性意义 (P均 <0 .0 0 1)。BOO组、可疑梗阻组和无梗阻组逼尿肌收缩功能正常级以上者分别占 74 .4 % (2 9/ 39)、2 7.8% (5 / 18)和 2 6 .7% (8/ 30 ) ,BOO组与另两组比较差异均有极显著性意义 (P?

Objective To evaluate pressure-flow study in assessment of dysuresia symptom in elderly male patients. Methods A total of 125 elderly male patients with dysuresia and prostatic enlargement underwent urodynamic examination.Their age ranged from 56 to 83 years with a mean of 68 years.If the patients urinated smoothly with satisfying urinary flow curve,the pressure-flow study would be performed on them.According to the results,the patients were classified as 3 groups:BOO,equivocal BOO and non-BOO groups.Their detrusor contractive function was classified as strong,normal,weak or very weak. Results Of the 125 patients undergoing urodynamic test,87 obtained definite pressure-flow study findings.Of the 87 patients,39 were with BOO,18 with equivocal BOO and 30 without BOO.In the BOO,equivocal BOO and non-BOO groups,detrusor pressure at maximum flow was (99.2±34.3) cmH 2O (1cmH 2O=0.098 kPa),(46.9±9.9)cmH 2O and (30.8±10.0)cmH 2O,respectively;intravesical opening pressure was (99.4±39.6) cmH 2O, (43.7±9.9) cmH 2O and (29.9±9.7) cmH 2O, respectively; minimum voiding detrusor pressure was (61.3±27.5) cmH 2O, (33.9±14.1)cmH 2O and (22.1±12.5)cmH 2O,respectively;and maximum detrusor pressure was (113.0±42.1)cmH 2O,(55.8±14.9)cmH 2O and (38.4±11.3)cmH 2O,respectively.The detrusor function was normal or strong in 74.4% (29/39) of patients with BOO,27.8%(5/18) of patients with equivocal BOO and 26.7% (8/30) of patients without BOO.All these parameters of the BOO group were higher than those of the equivocal BOO group and non-BOO group (both P<0.001). Conclusions Currently pressure-flow study is the only method and gold standard for diagnosis of BOO.Pressure-flow study provides great value in diagnosis of BOO and important assistance in choosing therapeutic procedure of BOO in elderly men with voiding complaints.