尿动力学检查对前列腺增生症所致膀胱出口梗阻的诊断价值

Value of urodynamics in diagnosis of bladder outflow obstruction in patients with benign protate hypertrophy

目的探讨尿动力检查对前列腺增生症(BPH)所致膀胱出口梗阻(BOO)的诊断价值。方法对274例BPH患者行尿动力学检查,联合应用A-G图和LinPURR图诊断BOO并分等级。结果诊断为BOO225例(82.1%),可疑BOO31例(11.3%),无BOO18例(6.6%);逼尿肌不稳定(DI)93例,逼尿肌低顺应性82例,逼尿肌活动低下(DUA)68例,逼尿肌—括约肌协同失调(DSD)19例。随着BOO程度加重,IPSS评分、残余尿、DI和DUA发生率呈升高趋势,而逼尿肌顺应性、最大尿流率(Qmax)呈下降趋势。结论尿动力学检查是诊断BOO的金标准,BPH患者可根据术前的尿动力学检查结果选择治疗方案。

Objective：To evaluate the value of urodynamics in diagnosis of bladder outflow obstruction （BOO） in the patients with benign prostate hyperplasia （BPH）. Methods： 274 patients with BPH were performed urodynamic test. BOO was diagnosed by combined with A-G nomogram and LinPURR （ Linear passive urethral resistance relation） , the degree of BOO was quantitated by LinPURR. Results： The diagnosis rate of BOO was 82.1% ,dubious BOO was 11.3% ,non-BOO was 6.6%, Destrusor instability （DI） was found in 93 cases,bladder compliance was reduced in 82 cases,destrusor underactivity （DUA） in 68 cases,destrusor sphincter dyssynergia （DSD） in 19 cases. The degree of BOO showed an increasing tendency such as IPSS score,post-voiding residual, DI and DUA, but a decreasing tendency with Qmax and bladder compliance. Conclusion：The urodynamics is the golden standard in diagnosis of BOO. The urodynamic results before operation for BPH is the basis of chosing the treatment.