压力-流率测定结合膀胱镜检在FBOO患者手术评估的意义

The significance of operation evaluation on pressure flow study and cystoscopy in female patients with bladder outlet obstruction

目的:探讨压力-流率测定结合膀胱镜检在女性膀胱出口梗阻(FBOO)患者手术评估的意义。方法:对35例怀疑FBOO患者进行压力-流率测定,将最大尿流率时逼尿肌压力(Pdet.Qmax)>4.90kPa,最大尿流率<15ml/s作为评估是否存在FBOO标准,同时行膀胱镜检示不同程度膀胱颈后唇抬高,隆起,可见膀胱憩室和膀胱小梁。术前逼尿肌收缩强度分为六级:极弱(VW)、弱减(W-)、弱加(W+)、正常减(N-)正常加(N+)和强烈(ST),把相应的患者分为六组,除了逼尿肌收缩极弱组保守治疗外,均行经尿道膀胱颈切开术。结果:35例患者存在不同程度的膀胱出口梗阻(BOO),3例术后尿失禁,经药物和针灸治疗后好转。结论:FBOO患者应通过压力-流率测定结合膀胱镜明确诊断,明确逼尿肌功能状态损害程度,以准确选择手术时机。逼尿肌收缩力正常下行经尿道膀胱颈切开术是治疗FBOO的最佳治疗方案。

Objective：To assess the significance of operation evaluation on Pressure Flow study and cystoscopy in female patients with bladder outlet obstruction （FBOO）. Method： Thirty-five FBOO patients were carryed out pressure. Flow study, Pdet. Qmax 〉4.90 kPa and Qmax 〈15 ml/s evaluate denom of FBOO. The diagnostic criteria of Cystoscopy was thai the bladder neck was close or narrowed,and was bladder diverticulum and bladder tra beculum. Etrusor muscle intensity were divided into six grade, for very weak, weak（-）, weak（＋） ,normal（- ）, normal（＋） and intensity, divideing all patients into six groups, all patients were were carryed out transurethral vesical neck incision in addilion to the patients that muscle intensity is very weak. Result：Thirty-five patients show invariably degree bladder outlet obstruction（BOO）, 17 cases show urinary incontinence in postoperation, but get better in acupuncture therapy and pharmacotherapy. Conclusion： FBOO patients should be carry out Pressure Flow study and cystoscopy to ascertain impairment degree of detrusor muscle. Transurethral vesical neck incision was recommended to treatment of FBOO patients with normal detrusor muscle myotility.