老年病科门诊良性前列腺增生症患者诊治现况

Cross-sectional investigation on diagnosis and treatment of benign prostatic hyperplasia in geriatrics outpatients

目的了解《中国良性前列腺增生症诊断治疗指南》公布以来老年病科门诊BPH诊断与治疗的基本情况。方法采用BPH诊断情况日报表(A表)、BPH良患者就医需求问卷(B表)、国际前列腺症状评分表(International Prostate Symptom Score,IPSS)、(C表)、BPH患者生活质量量表(QOL)(D表),对单月在湘雅二医院老年病科门诊就诊的BPH患者进行调查。结果2008年2月湘雅二医院老年病科门诊患者总计263人(女106人,男157人),其中诊断为BPH患者111人。医生开具的检查项目中病史询问、IPSS评分、生活质量评分(QualityOfLife,QOL)、腹部超声、PSA测定等均达到了100%。初诊患者与复诊组比较,确诊时间、IPSS评分、QOL评分、前列腺体积以及最大尿流率均有统计学差异。前列腺体积与PSA值在所有患者以及70岁、80岁人群组具正相关性,同时80岁组中前列腺体积与最大尿流率也具正相关。采用药物治疗者占58%。结论湘雅二医院老年病科门诊BPH患者的主要构成人群特征均与全国的情况基本接近,门诊医生能较好地遵从BPH诊疗指南来诊断与评估患者病情,但尚需要提高对于直肠指诊重要性的认识,在药物治疗选择上,以α受体阻滞剂使用率最高,其次为中药和植物制剂,5α还原酶抑制剂最低,α受体阻滞剂与5α还原酶抑制剂合用率也低于服用中药植物制剂率。

Objective To determine the information of diagnosis and treatment of benign prostatic hyperplasia （BPH） in geriatrics outpatients after publishment of the Chinese guideline for the manegement of benign prostatic hyperplasia in 2006.Methods Each outpatient identified with a BPH diagnosis in daily BPH diagnosis report form（A） of the Geriatrics outpatients was asked to complete BPH hospitalize requirement questionnaire（B）,IPSS questionnaire（C）,BPH QLS（D） in odd month 2008. Results Of 271 outpatients in Geriatrics department,106 female,157 male,111 patients were diagnosised as BPH. History inquisition,IPSS,QOL,abdominal ultrasonic examination,PSA test were all taken,there were statistically significant differences in diagnosis time,IPSS,QOL,prostate volume,Qmax between the initial visit group and return visit group. A positive association was found between prostate volume and PSA in whole patients and 70 years old group,80 years old group,there was a positive association between prostate volume and Qmax in 80 years old group. Medical treatment percentage was 58%.Conclusions Consultation rate,major characters of composition population of Geriatrics BPH outpatients are similar with nationwide situation. Geriatrics doctors can follow Chinese BPH guideline well,but their understanding of digital rectal examination need to be improved. The most common medical treatment is α-blockers,followed is phytotherapy,5α reductase inhibitiors,combination therapy percentage are also lower than phytotherapy′s.