良性前列腺增生患者的尿动力学分析

Urodynamic study of the benign prostatic hyperplasia

目的:分析良性前列腺增生患者的尿动力学数据,为合理治疗前列腺增生症提供依据。方法:2008年1月～2011年12月我院收治121前列腺增生患者,所有患者均经直肠指诊、泌尿系彩超、膀胱镜检查及抽血测前列腺特异抗原明确诊断前列腺增生。对所有患者行尿动力学检查。结果:121例患者中有118例存在膀胱出口梗阻,3例正常。118例膀胱出口梗阻患者中有4例膀胱逼尿肌收缩乏力,50例膀胱逼尿肌不稳定。114例患者(除去正常3例,膀胱逼尿肌收缩乏力4例)平均最大尿流率(8.32±3.15)mL/s,平均残余尿量(87.68±79.46)mL,平均最大尿流率时逼尿肌压(62.32±7.54)cmH2O,平均最大尿道闭合压为(86.43±18.35)cmH2O,平均前列腺尿道长度5.6 cm,与正常值有显著统计学差异(P<0.05)。7例患者不适合行手术治疗,50例患者行手术治疗后可能延迟显效。结论:尿动力学检查能避免前列腺增生患者手术治疗的盲目性。

Objective：To analyze the urodynamic data of the patients with benign prostatic hyperplasia and to provide evidence for the therapy. Methods ： 121 patients with benign prostatic hyperplasia in Heyuan People, s Hospital with mean age of 65.6 （ 46 to 82 years ）. All patients had intact history documents which included the results of cystoscopy, doppler, DRE and PSA. Results：118 cases were diagnosed with BOO （4 of them showed detrusor underactivity, 50 of them shewed detrusor instability） ,3 cases were normal. 114 patients （exclude 3 cases were normal and 4 cases showed detrusor underactivity） showed mean Qmax was （8.32 ± 3.15 ） mL/s, mean RV was （87.68 ± 79.46） mL, mean Pdet. max （62.32 ±7.54） cm H2 O, mean MUCP （ 86.43 ± 18.35 ） cmH2 O, mean PUL 5.6 cm. The statistic analysis showed significant difference with normal data （ P 〈 0. 05 ）. Therefore, 7 cases were not suit to take surgery treatment, and 50 cases undergone operation treatment may delay effect. Conclusions：Urodynamic tests can avoid the blindness in the surgery treatment of BPH.