62例帕金森病伴排尿困难患者临床处理

Management for Parkinson’s disease patients with urine voiding dysfunction:report of 62 cases

目的探讨帕金森病(Parkinson’s disease,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例,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。结论根据不同临床特点结合尿动力学检查采取相应治疗措施。

Objective To investigate the clinical management for Parkinson＇ s disease patients complicated with urine voiding dysfunction. Methods Totally 62 cases of Parkinson＇ s diseases complicated with urine voiding dysfunction were subjected, including 55 cases with acute and chronic urinary retention. Different treatment methods were employed according to the individual conditions and different results showed in urodynamic measurements that were performed in all subjects. Results Initially urethral catheterization and drug therapy （alphalreceptor blockers： Tamsulosin） were used in 24 cases. Then after successful voiding trial, urethral catheter were removed in 17 cases without urinary retention. Seven patients who could not urinate without catheter adopted clean intermittent self catheterization （CISC）, 15 patients accepted transurethral resection of the prostate （TURP）, 13 patients used suprapubic catheters, and 10 patients received outer utensil for gathering the urine. Conclusion According to various clinical symptoms and urodynamics of parkinsonian patients with urine voiding dysfunction, proper therapeutic measures should be taken.