术前尿流动力学检查对TURP术后疗效预测的研究

Value of Preoperative Urodynamics to the Prognosis of Transurethral Prostate Resection for Benign Prostatic Hyperplasia

目的: 探讨经尿道前列腺电切术(TURP)术前尿流动力学检查对术后疗效预测的价值. 方法: 对160例良性前列腺增生(BPH)患者TURP术前、术后8～11个月尿流动力学检查的参数及国际前列腺症状评分(IPSS)、生活质量评估(QOL)等进行统计学分析. 结果: TURP术后尿流动力学检查的参数(最大尿流率、最大尿流率时逼尿肌压力、Schafer分级、A-G值、尿道阻力因子、最大膀胱容量、有效膀胱容量)、IPSS及QOL均明显得到改善(P<0.001).术后IPSS、QOL分别与最大尿流率、最大尿流时逼尿肌压力、Schafer分级、A-G值、尿道阻力因子、最大膀胱容量、有效膀胱容量等呈极显著相关或显著相关. 结论: TURP术前尿流动力学检查有助于把握TURP手术指征、能预测术后患者症状改善的程度;TURP术前尿流动力学检查应列为重要检查项目,以杜绝手术的盲目性及预测术后疗效.

Objective: To establish the value of preoperative urodynamics to the outcome prediction of transurethral prostate resection(TURP) for benign prostatic hyperplasia(BPH). Methods: One hundred and sixty patients with BPH underwent urodynamic tests. Preoperative IPSS(International Prostate Symptom Score) and QOL(Quality of Life) were compared with those 8~11 months after operation. Results: The parameters of urodynamic tests(max.free flow,detrusor pressure at max. flow, Schafer grade, Abrams-Griffiths No, urethral resistance factor, cystometric capacity, effective capacity). IPSS and QOL were improved after operation(P< 0.001). And all the relative coefficients of linear dependence analysis, IPSS , QOL and max. free flow, detrusor pressure at max. flow, Schafer grade,Abrams-Griffiths value, urethral resistance factor, cystometric capacity, and effective capacity conducted postoperatively, were statistically significant. Conclusion: Preoperative urodynamics of transurethral prostate resection for benign prostatic hyperplasia may provide indication for operation and predict postoperative improvement of symptoms. Preoperative urodynamics should be considered as a routine examination.