前列腺增生患者术前进行尿流动力学检查的临床意义

Clinical Significance of Preoperative Urodynamic Study of BPH Patients

目的:探讨尿流动力学在前列腺增生患者术前检查的意义,从而为临床患者的诊治提供借鉴参考。方法:随机选取2012年9月-2013年2月本院收治的前列腺增生患者106例作为研究对象,手术前,对患者实施尿流率、尿道压、充盈膀胱测压、逼尿肌功能等尿流动力学检查,根据检查结果给予不同方法治疗,观察治疗效果。结果:106例患者中,不稳定膀胱6例,膀胱逼尿肌乏力11例,低顺应性膀胱33例,神经源性膀胱4例,逼尿肌亢进3例;尿流率检查91例(15例患者无法自解小便未行尿流率检查),Qmax在3～10 mL/s为71例,Qmax在10～15 mL/s为16例,Qmax>15 mL/s为4例;95例患者在尿道压检查中出现异常,其中膀胱出口梗阻89例,尿道狭窄6例。患者治疗前后的尿流动力学参数比较差异均有统计学意义(P<0.05)。结论:前列腺增生患者术前进行尿流动力学检查能比较客观地反映患者膀胱尿道功能状况,对于合理选择治疗方法,提高疗效意义重大,值得在临床上大力推广及应用。

Objective：To investigate the clinical significance of preoperative urodynamic study of BPH patients, so as to provide references for clinical diagnosis and treatment of patients.Method：106 cases of BPH treated in our hospital from September 2012 to February 2013 were randomly selected for the study,these patients were given different methods of treatment according to test results of urinary flow rate,urethral pressure,filling cystometry,detrusor function urodynamic studies before surgery.Result：Among the 106 patients,bladder instability were 6 cases,detrusor weakness were 11 cases,low compliance bladder were 33 cases,neurogenic bladder were 4 cases,detrusor hyperactivity were 3 cases;91 cases were checked flow rate（15 cases who were unable to self-examination did not undergo urine flow rate）, Qmax of 71 cases were 3-10 mL/s room,16 cases 10-15 mL/s,4 cases Qmax〉15 mL/s;95 cases had abnormal urethral pressure checks,including 89 cases were bladder outlet obstruction,6 cases were urethral stricture. Before and after treatment,the urinary flow mechanics parameters of the patients were compared,the differences had statistical significance （P〈0.05）.Conclusion：Urodynamic studies conducted before surgery can reflect the functional status of benign prostatic hyperplasia patients objectively,it has great significance for reasonable choice of treatment methods and improvement of the efficacy,so is worthy of promoting and application in clinical practice.