逼尿肌活动过度对良性前列腺增生患者的影响分析

Impacts of detrusor overactivity on patients with benign prostate hyperplasia

目的探讨逼尿肌活动过度（DO）对BPH患者的影响。方法对临床怀疑因BPH导致下尿路症状（LUTS）的47例患者按术前尿动力学检查中DO存在与否分为2组，其中有DO组22例，无DO组25例。2组均行TURP，分别记录患者相关临床资料，术前IPSS和QOL，Qmax残余尿及压力-流率检查等数据；术后随访并再次记录上述指标，采用SPSS10．0软件，对2组数据进行t检验。结果DO组、无DO组前列腺体积分别为（77±25）、（56±27）ml（P=0．02），初尿意时膀胱容量（104±36）、（161±54）ml（P=0．001），急迫尿意时膀胱容量（245±73）、（328±94）ml（P=0．006），术前残余尿（71±49）、（149±125）ml（P=0．015），linPURR梗阻级别4．63±0．95、3．35±1．90（P=0．014）。2组间手术前后IPSS及QOL比较差异均无统计学意义（P〉0．05）。结论前列腺体积大、膀胱出口梗阻明显的患者易存在DO。DO组患者膀胱容量及术前残余尿量明显少于无DO组。DO存在与否并不明显影响BPH患者的IPSS及QOL。

Objective To elucidate if detrusor overactivity（DO） has influence on patients with benign prostate hyperplasia. Methods Forty-seven patients who were suspected to suffered from BPH were divided into two groups according to whether have DO in pre-operative urodynamic analysis. There were 22 patients in DO group and 25 in non-DO group. All patients received transurethral resection of prostate （TURP）. Pre-operative variables such as relevant clinical data, International Prostate Symptom Score （IPSS）, quality of life （QOL） index, maximum urine flow rate（Qmax） and pressure-flow study data were recorded. Patients were monitored after operation and the corresponding data were recorded. Results Prostate size in DO group was （77±25）ml,and in non-DO group was （56±27） ml, P = 0.02; first desire bladder volume in DO group was （104 ± 36）ml, and in non-DO group was （161±54）ml,P=0. 001;urgent desire bladder volume in DO group was （245±73）ml,and in non-DO group was （328±94）ml, P=0. 006; pre-operative residual urine in DO group was （71± 49）ml,and in non-DO group was （149±125）ml,P=0. 015 ;IinPURR obstruction grade in DO group was 4.63±0.95,and in non-DO group was 3.35±1.90,P=0. 014. The IPSS and QOL before and after operation had no significant differences between the 2 groups. Conclusions The patients with larger prostates and more severe bladder outlet obstruction are more likely to have DO. Patients with DO had smaller bladder volume and residual urine volume before operation. DO has no significant effect on BPH patient＇s IPSS and QOL.