尿动力学对症状性前列腺增生的临床诊疗价值探讨

Discussion of the clinical value of urodynamics to diagnosis and surgical treatment in the BPH

目的:探讨症状性良性前列腺增生诊疗中尿动力学(UDS)的临床价值。方法:回顾分析59例残余尿<50 ml、以主观症状为主诉而首诊患者的术前尿动力学检查结果以及术后效果分析评估等临床资料。结果:患者共59例,年龄55～79岁,平均67.1岁。病程7～30个月,平均15.9个月。国际前列腺症状评分(IPSS)18～27分,生活质量评分(QOL)3～5分。经UDS结果显示,27例可疑膀胱出口梗阻(BOO),32例有不同程度BOO;逼尿肌轻微不稳定(DI)18例,逼尿肌收缩增强15例。最大尿流率(Qmax)7～11 ml/s,平均尿流率8 ml/s,患者选择经尿道前列腺电切术(TURP)。随访4～18个月,IPSS评分0～5分,QOL评分0～1分。测自由尿流率13～19 ml/s。各项指标与术前比较,差异均有统计学意义(P<0.05)。结论:UDS前列腺增生的诊疗提供客观依据及有重要指导意义,甚至是临床上非常规意义的手术指征。同时为疗效的判断提供客观依据。

Objective To study the clinical value of urodynamics to diagnosis and surgical treatment in the BPH. Method 59 cases were diagnosed with BPH for the first time and the residual urine was less than 50ml. Retrospectively analyzed the preoperative urodynamic data and the postoperational effect between Aug. 2003 to Mar. 2008. Results The patients＇ mean age was 67. 1 years （range ：55 -79years） . Course ：7- 30 months, average 15.9 months. International prostatic symptom score （IPSS） ：18- 27 scores. Quality of life score （QOL） ：3 - 5 scores. Urodynamic studies showed that 7 cases had been suspected with BOO ;30 cases were diagnosed with BOO; 18 cases had detru- sor instability （DI） ; 15 cases had detrnsor contraction highly. Maximum flow rate ：7-11 ml/s ; Average flow rate ： 8 ml/s. All the patients had been applied for transurethral resection of the prostate （TURP）. 59 cases were followed up for 4 -18 months. Postoperative IPSS ：0-5 scores QOL：0-1 scores. Freedom urinary flow rate was 13 - 19 ml/s. Compared with those of preoperation, the differences were statistically significant （ P 〈 0. 05）. Conclusion Uredynamics can offer objectivity evidence and guide significance for the BPH patients. Even the oper- ation indication of unconventonal meaning. And 1 can provide objective basis to treatment effect.