尿动力学检查术前对BPH患者TVP术后疗效的评价作用

Preoperation urodynamics appraise action in benign prostatic hyperplasis after transurethral electrovaporization

目的:探讨尿动力学检查在术前对前列腺增生(BPH)患者行经尿道前列腺电汽化术(TVP)术后疗效的评价作用。方法:对800例拟行TVP的BPH患者术前行尿动力学检查、国际前列腺症状(IPSS)评分,并于术后随访1年,观察最大尿流率I、PSS评分。结果:800例BPH患者术前最大尿流率均<15 ml/s,IPSS评分平均>29分。根据术前最大尿道压力、最大尿道压力与充盈时膀胱最大压力的关系、膀胱顺应性及是否存在尿道外括约肌与膀胱逼尿肌压力不协调等指标共分为四组。术后1年最大尿流率平均分别为18.3 ml/s、17.9 ml/s、9.2 ml/s和8.2 ml/s,IPSS评分平均分别为12分、11分、23分和26分。其中各组术后最大尿流率>15 ml/s,分别占89.8%、85.5%、29.2%和22.5%。Ⅰ组、Ⅱ组术后各项指标与Ⅲ组、Ⅳ组比较差异均有统计学意义(P<0.05)。结论:尿动力学检查对BPH患者行TVP术的疗效有良好的评价作用,可为BPH患者采用何种治疗方法提供重要依据。

Objective： To evaluate preoperation urodynamics appraise action in benign prostatic hyperplasis after transurethral electrovaporization, Methods;To make urodynamics checking and IPSS in 800 cases benign prostatic hyperplasis（BPH） before transurethral electrovaporization（TVP）,One year later, to determine Maximun flow rate（Qmax） and International Prostatic Symptom Score（ IPSS）, make retrospective analyzing. Results： In 800 cases preoperation all Qmax was lower than 15 ml/s , IPSS were greater than 29, To divide into four groups according to urodynamics checking preoperation including max urethra pressure , relation of max urethra pressure and max blad der filling pressure,bladder stabilization, incompatibillty of urethra outer sphincter and bladder detrusor pressure exsited or not, Qmax average separately was 18.3 ml/s,17.9 ml/s, 9. 2 ml/s,8.2 ml/s after one year, IPSS aver age separately was 12、11、23、26. The rate of patients in every group postoperation Qmax being greater than 15 ml/s separately was 89.8%,85.5%,29.2%,22.5%, Difference between one,two group postoperationevery target separately and three,four group has remarkable（ P 〈0. 05）. Conclusions： Urodynamics checking has a good appraise action to prognosis in BPH patients of making TVP, and provide important basis for using treatment ways in BPH patients.