小体积良性前列腺增生治疗方式的选择

Therapy of patients with small size BPH

目的 :寻找治疗小体积良性前列腺增生 (BPH )患者的最佳治疗方式。方法 :对 42例小体积 BPH患者采用直肠 B超及尿动力学检查相结合方法进行综合分析 ,如移行区指数 (TZI) >0 .4且存在膀胱颈梗阻者 ,采用TURP治疗 ;如 TZI≤ 0 .4且存在膀胱颈梗阻者 ,则行药物治疗。结果 :TZI>0 .4者 TU RP治疗效果好 (93.3% ) ,药物治疗效果较差 (5 0 .0 % ) ;TZI≤ 0 .4者药物治疗优于 TU RP治疗 ;TZI≤ 0 .4而无膀胱颈梗阻者手术及药物治疗均无效。结论 :治疗小体积 BPH患者的原则是尿动力学检查有膀胱颈梗阻存在 ,如 TZI>0 .4,宜行 TU RP治疗 ;如 TZI<0 .4,则行药物治疗 ;如尿动力学检查无膀胱颈梗阻存在 ,则应继续寻找病因。

Purpose:To evaluate the therapy of patients with small size BPH.Methods:Data of 42 patients with small size BPH was analyzed retrospectively.Results:The effect of TURP was good in patients whose transition zone index (TZI)≥ 0.4 and who had bladder outlet obstruction (BOO);These patients had poor response to drug therapy(4/8).The effect of TURP was bad in patients whose TZI<0.4 and who had BOO, but they had a good response to drug therapy(13/13). The patients without BOO and with their TZI< 0.4 had not effect(0/4).Conclusions:Only the patients with small size BPH who have BOO need therapy. If their TZI> 0.4 , the best choice of therapy is TURP. The patients whose TZI< 0.4 had better take drug therapy.