帕金森病伴排尿功能障碍特点及临床处理体会(附62例分析)

Characteristics and Treatment of Parkinson Disease Complicated with Urine Voiding dysfunction:a Report of 62 Cases

【目的】探讨帕金森病(PD)患者的排尿功能紊乱的治疗。【方法】分析临床PD合并排尿功能障碍患者共62名,其中55例出现急、慢性尿潴留者,均行尿流动力学检查,根据病情及部分尿流动力学检查结果,采取不同治疗方法。【结果】留置尿管患者24例,其中拔除尿管后经口服α1-受体阻滞剂坦索罗辛可逐渐恢复自行排尿者17例,7例不能自行排尿患者采取清洁间歇性自家导尿术;经尿道前列腺汽化电切15例,耻骨上膀胱穿刺造瘘术13例;采用外部集尿器方法10例。【结论】排尿功能紊乱是PD患者常见并发症,其治疗措施应根据病人的具体情况而定;老年男性帕金森病患者排尿障碍症状须警惕前列腺增生合并的出口梗阻。

[Objective]To investigate the treatment of Parkinson disease complicated with urine voiding dysfunction. [Methods]Sixty two cases of Parkinson disease were complicated with urine voiding dysfunction, and 55 cases of them had acute and chronic urinary retention. All the patients accepted urodynamic measurement. And different treatment methods were used. [Results] Twenty four cases retained urinary catheter, and 17 of them retrieved voluntary micturition after urinary catheter was pulled out and alpha1-receptor blockers （Tamsulosin） was taken orally. Seven patients without voluntary micturition adopted clean intermittent selfcatheterization （CISC）. Fifteen cases accepted transurethral resection of the prostate （TURP）. Thirteen cases accepted suprapubic puncture fistulation, and 10 cases accepted outer utensil for gathering the urine. [Conclusion] Voiding dysfunction is a common complication of Parkinson disease. Different methods should be used for the treatment of Parkinson disease complicated with voiding dysfunction according to the patients＇ pathogenetic condition. Aged male patients with Parkinson disease should be cautious for the outlet obstruction secondary to prostatic hyperplasia.